Individual
AMY LEE STAUBACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
15855 19 MILE RD, CLINTON TWP, MI 48038-3504
(586) 263-2300
Mailing address
15855 19 MILE RD, CLINTON TWP, MI 48038-3504
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008700
MI
Other
Enumeration date
06/07/2018
Last updated
02/05/2021
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