Individual
MS. LAUREN VINZANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
14671 TELEGRAPH RD, REDFORD, MI 48239-3300
(858) 602-2029
Mailing address
27320 ALGER BLVD, MADISON HEIGHTS, MI 48071-3224
(858) 602-2029
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601008302
MI
363AS0400X
Surgical Physician Assistant
Primary
PA61003199
WA
Other
Enumeration date
08/09/2017
Last updated
01/24/2020
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