DEREK SUSALLA

ROCHESTER HILLS, MI
NPI1508392796
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  5601008192)
Enumeration Date2017-05-07
Last Update Date2017-05-07
Business Address
-- DEREK SUSALLA
441 S LIVERNOIS RD
ROCHESTER HILLS, MI 48307-2584
Phone number: 248-608-8800
Mailing Address
-- DEREK SUSALLA
615 WOODGLEN CIR APT 206
AUBURN HILLS, MI 48326-4526
Phone number:
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