Individual
DR. LISA ALLYN MANZ DULAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20030 MACK AVE, GROSSE POINTE WOODS, MI 48236-2323
(313) 884-3380
(313) 884-9756
Mailing address
20030 MACK AVE, GROSSE POINTE WOODS, MI 48236
(313) 884-3380
(313) 884-9756
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
43010053049
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3491350
—
MI
Enumeration date
03/22/2006
Last updated
01/03/2012
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