DIANE AMIR MANSOUR

WATERFORD, MI
NPI1710589429
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: MI  4704304113)
Enumeration Date2020-11-09
Last Update Date2020-11-09
Business Address
DIANE AMIR MANSOUR AGNP
5220 HIGHLAND RD STE 240
WATERFORD, MI 48327-1973
Phone number: 248-237-6580
Mailing Address
DIANE AMIR MANSOUR AGNP
6180 CHESHIRE PARK DR
CLARKSTON, MI 48346-4815
Phone number: 248-505-2813
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