Individual
EBONY LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
31461 BLOCK ST APT 303, GARDEN CITY, MI 48135-1958
(313) 686-4629
Mailing address
31461 BLOCK ST APT 303, GARDEN CITY, MI 48135-1958
(313) 686-4629
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703112106
MI
Other
Enumeration date
02/27/2015
Last updated
02/27/2015
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