Individual
SUSSANAH TABOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
7145 COLCHESTER LN, YPSILANTI, MI 48197-1871
(678) 777-9767
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703098155
MI
Other
Enumeration date
10/14/2015
Last updated
10/14/2015
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