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Individual

MS. COLETTE MARIE ICASIANO CLAYTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.S., P.A.-C

Contact information

Practice address
39621 GARFIELD RD, CLINTON TOWNSHIP, MI 48038-4302
(586) 226-5555
(586) 226-4441
Mailing address
47045 ROSEMARY RD, MACOMB, MI 48044-2582
(586) 744-5185

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008354
MI

Other

Enumeration date
09/26/2017
Last updated
09/01/2022
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