Provider Information for 1861033128
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PAIGE ALEXANDRA HENRY
Sex: Female
NPI: 1861033128
Last Updated: 2019-10-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1861033128 | ||||||||
| Enumeration Date | 2019-10-07 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 300 RIVERFRONT DR UNIT 26D DETROIT, MI 48226-4586 United States Phone: 313-980-2947 | Fax: | ||||||||
| Primary Practice Address | 300 RIVERFRONT DR UNIT 26D DETROIT, MI 48226-4586 United States Phone: 313-980-2947 | Fax: | ||||||||
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