Individual
ELIA MTIMAVALYE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
910 PIERCE RD, LANSING, MI 48910-5274
(517) 410-7313
Mailing address
910 PIERCE RD, LANSING, MI 48910-5274
(517) 410-7313
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
AF330334043
MI
Other
Enumeration date
05/06/2015
Last updated
05/06/2015
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