Individual
MRS. MARIA-CELIA FLORENCE REVITA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Mailing address
13101 ALLEN RD, SOUTHGATE, MI 48195-2216
(734) 785-7700
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
L2427174
MI
Other
Enumeration date
08/27/2014
Last updated
08/27/2014
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