Individual
MARCELLA MARIE LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17625 REED ST, MELVINDALE, MI 48122-1142
(313) 282-9151
(313) 429-3550
Mailing address
PO BOX 3126, MELVINDALE, MI 48122-0126
(313) 465-5173
(313) 429-3550
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
MI
Other
Enumeration date
08/12/2008
Last updated
08/12/2008
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