Individual
CAROL LYNN PIESIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
110 N ELM AVE, JACKSON, MI 49202-3571
(517) 788-6760
(517) 788-3029
Mailing address
DEPARTMENT 272801, PO BOX 67000, DETROIT, MI 48267-2728
(517) 841-6913
(517) 841-6917
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003005
MI
Other
Enumeration date
05/23/2006
Last updated
03/14/2008
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