PREVENTATIVE PRIMARY CARE
Organization (NPI-2)
Active
Nurse Practitioner, Family
Provider Information
- NPI Number
1043531007- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 20600 EUREKA RD STE 522, TAYLOR, MI, 481805373
- Phone
- (734) 225-6507
- Fax
- (734) 225-6513
Specialties & Taxonomies
Nurse Practitioner, Family
Primary License: MI #4704190451