Individual
NERISSA COBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17197 SHIELDS ST, DETROIT, MI 48212-1214
(313) 624-6773
Mailing address
17197 SHIELDS ST, DETROIT, MI 48212-1214
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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