Individual
PATRICIA LYNN WEISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
44201 DEQUINDRE RD, TROY, MI 48085-1117
(248) 964-2219
Mailing address
3968 MAY CENTER RD, LAKE ORION, MI 48360-2522
(248) 377-9250
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601002253
MI
Other
Enumeration date
07/10/2007
Last updated
07/10/2007
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