Individual
MISS TRACY KISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3850 2ND ST, WAYNE, MI 48184-1775
(313) 657-7762
Mailing address
15546 MEYER AVE, ALLEN PARK, MI 48101-2744
(313) 657-7762
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
10/07/2021
Last updated
10/07/2021
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