Individual
CARLEATHA GARY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
19574 COLMAN ST, CLINTON TWP, MI 48035-3947
(248) 939-3174
Mailing address
19574 COLMAN ST, CLINTON TWP, MI 48035-3947
(248) 939-3174
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
10/02/2016
Last updated
10/02/2016
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