Individual
MRS. LYDIA ORLENE RISING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
43902 WOODWARD AVE, SUITE 240, BLOOMFIELD HILLS, MI 48302-5011
(248) 454-7650
(248) 454-9794
Mailing address
1251 LAKE CRESCENT DR, BLOOMFIELD HILLS, MI 48302-2813
(248) 855-8077
(248) 855-4653
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601003506
MI
Other
Enumeration date
07/17/2006
Last updated
02/04/2009
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