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1578113593
LUIZA LICA
CANTON, MI
NPI
1578113593
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2019-09-12
Last Update Date
2019-09-12
Business Address
LUIZA LICA
246 PRINCESS DR
CANTON, MI 48188-1142
Phone number: 734-629-7876
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Mailing Address
LUIZA LICA
246 PRINCESS DR
CANTON, MI 48188-1142
Phone number:
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