Individual
DR. LENISE ANNE BANSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
42452 HAYES RD, SUITE 3, CLINTON TOWNSHIP, MI 48038-6771
(586) 263-3130
(586) 263-5183
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-7190
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301047653
MI
Other
Enumeration date
01/23/2007
Last updated
09/10/2021
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