THRESIAMMA IDICHANDY

DETROIT, MI
NPI1063422319
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MI  4704171067)
Enumeration Date2006-08-09
Last Update Date2007-07-08
Business Address
Mrs. THRESIAMMA IDICHANDY Nurse practitioner
4646 JOHN R ST
DETROIT, MI 48201-1916
Phone number: 313-576-1000
Mailing Address
Mrs. THRESIAMMA IDICHANDY Nurse practitioner
5085 WESTMORELAND DR
TROY, MI 48085-3443
Phone number: 248-528-8106
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