Individual
MYRNA LOPEZ MCCALLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-4766
Mailing address
571 BERTHA AVE, WINDSOR, ONTARIO N8P 1-B6
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704209499
MI
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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