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1164621009
MARIE VALE BOOMER
NOVI, MI
NPI
1164621009
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: MI 5601001569)
Enumeration Date
2007-07-12
Last Update Date
2015-12-29
Business Address
-- MARIE VALE BOOMER PA-C
28455 HAGGERTY RD STE 200
NOVI, MI 48377-2982
Phone number: 248-893-3200
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Mailing Address
-- MARIE VALE BOOMER PA-C
6676 SOLUTIONS CTR
CHICAGO, IL 60677-6006
Phone number: 248-893-3200
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