Individual
MARIA EWING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
13093 CANONBURY ST, DETROIT, MI 48205-3240
(313) 208-6987
Mailing address
13093 CANONBURY ST, DETROIT, MI 48205-3240
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703116119
MI
Other
Enumeration date
11/15/2016
Last updated
11/15/2016
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