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1053049510
SERAPHINA PROVENZANO
DEARBORN, MI
NPI
1053049510
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MI 5501301928)
Enumeration Date
2022-08-12
Last Update Date
2023-08-10
Business Address
SERAPHINA PROVENZANO DPT
5500 AUTO CLUB DR
DEARBORN, MI 48126-2779
Phone number: 313-982-8266
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Mailing Address
SERAPHINA PROVENZANO DPT
1 FORD PL
DETROIT, MI 48202-3450
Phone number:
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