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Individual

BRIAN GROSSMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
14575 SOUTHFIELD RD, ALLEN PARK, MI 48101-2640
(313) 381-8787
Mailing address
460 E CAMBOURNE ST, FERNDALE, MI 48220-1306
(248) 672-9442

Taxonomy

Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704306156
MI

Other

Enumeration date
04/13/2018
Last updated
04/13/2018
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