Individual
WILLIE WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9500 CHALMERS ST APT 1, DETROIT, MI 48213-4417
(313) 671-9124
Mailing address
19919 MCCORMICK ST, DETROIT, MI 48224-1147
(313) 433-6375
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
—
Other
Enumeration date
04/22/2024
Last updated
04/22/2024
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