Individual
TACARRA THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5599 JOHN C LODGE FWY, DETROIT, MI 48202-3346
(313) 452-1090
Mailing address
5599 JOHN C LODGE FWY, DETROIT, MI 48202-3346
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703129119
MI
Other
Enumeration date
01/26/2026
Last updated
01/26/2026
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