Individual
EDGAR JOSE PAZ CONCHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-7233
Mailing address
3212 WOODLAND AVE, ROYAL OAK, MI 48073-2358
(248) 321-2209
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
4351051494
MI
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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