Individual
CARL ROBERT MENGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
393 E CAMBOURNE ST, FERNDALE, MI 48220-1311
(248) 640-8692
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703063055
MI
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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