Organization
TIFFANY GOSHATT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TIFFANY GOSHATT (LPN)
(313) 799-6037
Entity
Organization
Contact information
Practice address
18570 SAN JOSE BLVD, LATHRUP VILLAGE, MI 48076-7801
(313) 799-6037
Mailing address
18570 SAN JOSE BLVD, LATHRUP VILLAGE, MI 48076-7801
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
4703106260
MI
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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