Individual
MRS. TERESA JILL MCCORMACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2215 FULLER RD, ANN ARBOR, MI 48105-2303
(734) 769-7100
Mailing address
6855 CARPENTER RD, YPSILANTI, MI 48197-8845
(734) 572-7578
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704172259
MI
Other
Enumeration date
02/03/2012
Last updated
02/03/2012
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