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Individual

LAUREN PATZKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
32669 WARREN RD, GARDEN CITY, MI 48135-1677
(734) 762-0798
Mailing address
305 N LEROY ST, FENTON, MI 48430-2729
(810) 629-0336

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006523
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5822464
BLUE CROSS
MI
Enumeration date
05/17/2013
Last updated
07/09/2013
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