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1417924499
SANDRA LODGE
TROY, MI
NPI
1417924499
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601003636)
Enumeration Date
2006-03-08
Last Update Date
2017-10-23
Business Address
SANDRA LODGE
44201 DEQUINDRE RD
TROY, MI 48085-1117
Phone number: 248-964-5000
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Mailing Address
SANDRA LODGE
3601 W 13 MILE RD 400-FSC/PCS
ROYAL OAK, MI 48073-6712
Phone number:
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