Individual
SAGE RYAN CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
22201 MOROSS RD, PBII SUITE 70, DETROIT, MI 48236-2169
(313) 343-3700
(313) 343-4756
Mailing address
22201 MOROSS RD, PBII SUITE 70, DETROIT, MI 48236-2169
(313) 343-3700
(313) 343-4756
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5101019349
MI
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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