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Individual

MS. MARY ALICE MARTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
26184 OUTER DR, LINCOLN PARK, MI 48146-2084
(313) 389-7500
Mailing address
24663 ORCHARD ST, TAYLOR, MI 48180-5101
(734) 946-4915

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704159696
MI

Other

Enumeration date
01/27/2012
Last updated
01/27/2012
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