Organization
LIVONIA WELLNESS SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUAN E FERNANDEZ (PRESIDENT)
(786) 291-5853
Entity
Organization
Contact information
Practice address
31705 PLYMOUTH RD, LIVONIA, MI 48150-1905
(734) 422-0246
(734) 422-0372
Mailing address
31705 PLYMOUTH RD, LIVONIA, MI 48150-1905
(734) 422-0246
(734) 422-0372
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
02/14/2007
Last updated
02/06/2008
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