Individual
IAN CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4228 S FULTON PL, ROYAL OAK, MI 48073-6358
(989) 316-9882
Mailing address
4228 S FULTON PL, ROYAL OAK, MI 48073-6358
(989) 316-9882
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
07/14/2016
Last updated
07/14/2016
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