Individual
MRS. AUDREY VIZZACCARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A.-C.
Contact information
Practice address
1261 SOUTH LAPEER RD, STE 201, LAKE ORION, MI 48360
(248) 814-7546
(248) 814-8900
Mailing address
1261 SOUTH LAPEER RD, STE 201, LAKE ORION, MI 48360
(248) 814-7546
(248) 814-8900
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601003044
MI
Other
Enumeration date
04/14/2008
Last updated
04/14/2008
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