Individual
OMAR ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
24513 STAR VALLEY DR, SAINT CLAIR SHORES, MI 48080-3178
(313) 703-3352
Mailing address
24513 STAR VALLEY DR, SAINT CLAIR SHORES, MI 48080-3178
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703081173
MI
Other
Enumeration date
12/18/2017
Last updated
12/18/2017
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