Individual
LILLIE PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
418 N ANN ARBOR ST, SALINE, MI 48176-1032
(734) 883-1548
Mailing address
418 N ANN ARBOR ST, SALINE, MI 48176-1032
(734) 883-1548
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
P412522135964
MI
Other
Enumeration date
11/09/2016
Last updated
11/09/2016
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