Individual
MRS. ELIZABETH FAY KUBALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.P.N.
Contact information
Practice address
1511 16TH ST, WYANDOTTE, MI 48192-3300
(734) 285-6455
Mailing address
1511 16TH ST, WYANDOTTE, MI 48192-3300
(734) 285-6455
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703045822
MI
Other
Enumeration date
01/05/2007
Last updated
07/09/2007
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