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1174845846
LISA KOTZEN
ROYAL OAK, MI
NPI
1174845846
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Former Name
LISA JOHNIDES JOHNIDES
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601005577)
Enumeration Date
2010-02-23
Last Update Date
2021-01-22
Business Address
LISA KOTZEN PA
3555 W 13 MILE RD STE N120
ROYAL OAK, MI 48073-6710
Phone number: 855-863-8761
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Mailing Address
LISA KOTZEN PA
26901 BEAUMONT BLVD STE 3D
SOUTHFIELD, MI 48033-3849
Phone number:
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