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1063592046
STACEY LYNN PRANTERA
DETROIT, MI
NPI
1063592046
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601004380)
Enumeration Date
2006-10-16
Last Update Date
2023-10-09
Business Address
STACEY LYNN PRANTERA PA-C
2799 W GRAND BLVD
DETROIT, MI 48202-2608
Phone number: 313-916-0841
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Mailing Address
STACEY LYNN PRANTERA PA-C
2799 W GRAND BLVD # K-17
DETROIT, MI 48202-2608
Phone number: 313-916-2436
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