Provider Information for 1154746303
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ANNIE ALLEN
Sex: Female
NPI: 1154746303
Last Updated: 2014-02-25
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1154746303 | ||||||||||||
| Enumeration Date | 2014-02-25 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 22855 ESSEX WAY ST APT 522 SOUTHFIELD, MI 48033-3342 United States Phone: 313-615-6323 | Fax: | ||||||||||||
| Primary Practice Address | 17800 E WARREN AVE DETROIT, MI 48224-1441 United States Phone: 313-343-5301 | Fax: | ||||||||||||
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