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1013514702
LEEZA FORTNER
DETROIT, MI
NPI
1013514702
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-10-06
Last Update Date
2020-10-06
Business Address
LEEZA FORTNER
259 MACK AVE STE 4514
DETROIT, MI 48201-2427
Phone number: 313-577-4723
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Mailing Address
LEEZA FORTNER
33708 LIPKE ST
CLINTON TOWNSHIP, MI 48035-3618
Phone number: 586-846-1282
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