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1427664986
VITA FONTANA
DETROIT, MI
NPI
1427664986
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MI 4704299351)
Enumeration Date
2020-09-21
Last Update Date
2020-09-21
Business Address
VITA FONTANA
22341 W 8 MILE RD
DETROIT, MI 48219-1217
Phone number: 313-499-3630
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Mailing Address
VITA FONTANA
18058 PLAYER DR
MACOMB, MI 48042-1772
Phone number: 586-215-7192
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