Individual
IVY MCWILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1292 LEFORGE RD APT D3, YPSILANTI, MI 48198-3550
(313) 656-9787
Mailing address
1292 LEFORGE RD APT D3, YPSILANTI, MI 48198-3550
(313) 656-9787
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
M245347622244
MI
Other
Enumeration date
10/18/2016
Last updated
10/18/2016
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