Individual
RODI OLLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
44068 RUSHCLIFFE DR, STERLING HEIGHTS, MI 48313-5900
(586) 883-4749
Mailing address
44068 RUSHCLIFFE DR, STERLING HEIGHTS, MI 48313-5900
(586) 883-4749
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704321544
MI
Other
Enumeration date
02/23/2021
Last updated
02/23/2021
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