Individual
STACY GISSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
28000 WOODWARD AVE, SUITE 100, ROYAL OAK, MI 48067-0960
(248) 395-3777
(248) 395-3370
Mailing address
28000 WOODWARD AVE, SUITE 100, ROYAL OAK, MI 48067-0960
(248) 395-3777
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703107589
MI
Other
Enumeration date
01/12/2017
Last updated
01/12/2017
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