Individual
RICHARD SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1427 PINGREE AVE, LINCOLN PARK, MI 48146-2094
(313) 948-1597
Mailing address
1427 PINGREE AVE, LINCOLN PARK, MI 48146-2094
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
01/04/2020
Last updated
01/04/2020
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