Individual
LISA EASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
24731 RENSSELAER ST, OAK PARK, MI 48237-1772
(248) 372-1995
Mailing address
24731 RENSSELAER ST, OAK PARK, MI 48237-1772
(248) 372-1995
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704235841
MI
Other
Enumeration date
09/23/2016
Last updated
09/23/2016
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