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Individual

JANELL DIANE WILCOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
19675 ALLEN RD, BROWNSTOWN TWP, MI 48183-1021
(313) 492-0331
(734) 479-1408
Mailing address
8509 SHERWOOD DR, GROSSE ILE, MI 48138-3003
(734) 620-0116

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003918
MI
363AM0700X
Medical Physician Assistant
5601003918
MI

Other

Enumeration date
06/02/2006
Last updated
02/03/2021
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