Individual
LAURA GINOZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
18263 E 10 MILE RD, SUITE D, ROSEVILLE, MI 48066-5805
(734) 464-0887
(734) 402-0254
Mailing address
36115 SCHOOLCRAFT RD, LIVONIA, MI 48150-1216
(734) 464-0887
(734) 402-0254
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005561
MI
363A00000X
Physician Assistant
PA 01248
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
480F37288
BLUE CROSS
MI
Enumeration date
06/27/2006
Last updated
08/06/2014
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