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1285753004
KIMBERLY MIX
DETROIT, MI
NPI
1285753004
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: MI 5601002397)
Enumeration Date
2007-03-29
Last Update Date
2009-03-26
Business Address
KIMBERLY MIX PA-C
6071 W OUTER DR
DETROIT, MI 48235-2624
Phone number: 313-966-3300
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Mailing Address
KIMBERLY MIX PA-C
6071 W OUTER DR SGR OBGYN 5TH FL
DETROIT, MI 48235
Phone number: 313-966-3246
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