Individual
DR. TRACEY DEBOLT WENTZ
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
5301 E HURON RIVER DR, CLINICAL LABORATORY-ST JOSEPH HOSPITAL, YPSILANTI, MI 48197-1051
(734) 712-5989
(734) 712-2244
Mailing address
3820 WYNNSTONE DR, ANN ARBOR, MI 48105-2879
(734) 769-5841
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301044723
MI
Other
Enumeration date
06/08/2006
Last updated
07/08/2007
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