Individual
DAWANDA COLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
23074 OLYMPIA DR, CLINTON TWP, MI 48036-4600
(470) 779-4054
Mailing address
23074 OLYMPIA DR, CLINTON TWP, MI 48036-4600
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703131634
MI
Other
Enumeration date
04/09/2026
Last updated
04/09/2026
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