Individual
KENISHA CHASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15565 NORTHLAND DRIVE 411W, SOUTHFIELD, MI 48075
(248) 559-5301
(248) 559-5692
Mailing address
15565 NORTHLAND DRIVE ST 411W, SOUTHFIELD, MI 48075
(248) 559-5301
(248) 559-5692
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
10/10/2014
Last updated
10/10/2014
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