Individual
MRS. LAURA ANNE CONSTANTINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(248) 978-5909
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601007950
MI
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
09/08/2016
Last updated
05/08/2023
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