Individual
MS. ALICIA WYNNE TUBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
470415612
MI
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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