Individual
MRS. GAYLE ANNE ANTONELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
122 W MAIN ST, MANCHESTER, MI 48158-1002
(734) 428-8381
(734) 428-9066
Mailing address
122 W MAIN ST, MANCHESTER, MI 48158-1002
(734) 428-8381
(734) 428-9066
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002116
MI
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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