Individual
NICHOLE SANDOVAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1427 PINGREE AVE, LINCOLN PARK, MI 48146-2094
(313) 784-7489
Mailing address
1427 PINGREE AVE, LINCOLN PARK, MI 48146-2094
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
02/14/2018
Last updated
02/14/2018
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