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1114781747
BETHANY LYNN PARK
SOUTHFIELD, MI
NPI
1114781747
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601012241)
Enumeration Date
2024-02-13
Last Update Date
2024-02-13
Business Address
BETHANY LYNN PARK PA-C
27177 LAHSER RD
SOUTHFIELD, MI 48034-4714
Phone number: 989-277-6478
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Mailing Address
BETHANY LYNN PARK PA-C
1521 ROYAL OAK ST SW
WYOMING, MI 49509-2711
Phone number: 989-277-6478
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