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1912660929
LARISA IACOBAN
CLINTON TOWNSHIP, MI
NPI
1912660929
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601011348)
Enumeration Date
2021-10-17
Last Update Date
2024-12-16
Business Address
LARISA IACOBAN
43361 COMMONS DR
CLINTON TOWNSHIP, MI 48038-1109
Phone number: 586-745-3006
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Mailing Address
LARISA IACOBAN
43361 COMMONS DR
CLINTON TOWNSHIP, MI 48038-1109
Phone number: 586-745-3006
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