Individual
MRS. MINI M TOMMY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4967 CROOKS RD, SUITE 130, TROY, MI 48098-5801
(248) 952-1601
(248) 952-1614
Mailing address
4967 CROOKS RD, SUITE 130, TROY, MI 48098-5801
(248) 952-1601
(248) 952-1614
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704204835
MI
Other
Enumeration date
05/24/2011
Last updated
08/26/2015
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