Individual
MR. TIM CHARLES DESANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30808 ISLAND DR, GIBRALTAR, MI 48173-9547
(734) 915-1270
(734) 250-7377
Mailing address
30808 ISLAND DR, GIBRALTAR, MI 48173-9547
(734) 915-1270
(734) 250-7377
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
06/19/2009
Last updated
11/13/2009
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