Individual
MR. LARRY SCOTT FITZGERALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
43825 MICHIGAN AVE STE 1, CANTON, MI 48188-2551
(734) 331-3088
Mailing address
37450 SCHOOLCRAFT RD STE 110, LIVONIA, MI 48150-1000
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
4724201358
MI
Other
Enumeration date
08/20/2020
Last updated
08/20/2020
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