Individual
MRS. CYNTHIA J PETRACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
16001 W 9 MILE RD, SOUTHFIELD, MI 48075-4818
(248) 849-8025
(248) 849-8256
Mailing address
19010 HILTON DR, SOUTHFIELD, MI 48075-1721
(248) 352-5831
(248) 352-4204
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704130122
MI
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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