Individual
LACACIA RIVERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
32100 TELEGRAPH RD STE 185, BINGHAM FARMS, MI 48025-2453
(248) 712-4266
Mailing address
13973 FARMINGTON RD, LIVONIA, MI 48154-5403
(734) 855-4490
(248) 712-4381
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
—
—
Other
Enumeration date
07/19/2019
Last updated
12/15/2022
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