Individual
LISA MODZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
26901 BEAUMONT BLVD, SOUTHFIELD, MI 48033-3849
(947) 522-1313
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(947) 522-1859
(947) 522-0307
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
—
—
Other
Enumeration date
05/09/2019
Last updated
05/09/2019
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