Life- Alysis Kidney Center, Llc

NPI 1255442190 - Health Maintenance Organization - 302R00000X

NPI Details
NPI 1255442190
Enumeration Date 08/31/2006
Last Updated 01/23/2013
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name LYLE MARUICE LYLE
Position PARTNER
Phone (313) 371-5433
Fax (313) 371-6937
Practice Location
5830 CONNER ST
DETROIT MI, 48213-3458, US
Phone (313) 371-5433
Fax (313) 371-6937
Business Location
5830 CONNER ST
DETROIT MI, 48213-3458, US
Phone (313) 371-5433
Fax (313) 371-6937
Toxanomy
Taxonomy Code 302R00000X
License State Michigan
License Number 302R00000X
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According to our database, Life- Alysis Kidney Center, Llc NPI is 1255442190, taxonomy code is 302R00000X and license number is 302R00000X, license state is located at Michigan. Life- Alysis Kidney Center, Llc physically located at 5830 Conner St, Detroit MI, 48213-3458. NPI Number 1033115704 has the healthcare provider type.

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1255442190 NPI number is provided on an as is basis without warranty of any kind. 1255442190 is maintained by the National Plan & Provider Enumeration System. The contents of Life- Alysis Kidney Center, Llc are for informational purposes only.