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1972156818
LEISA DETTLOFF
TROY, MI
NPI
1972156818
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MI 4704292580)
Enumeration Date
2019-07-19
Last Update Date
2022-07-15
Business Address
LEISA DETTLOFF
44201 DEQUINDRE RD
TROY, MI 48085-1117
Phone number: 248-964-5000
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Mailing Address
LEISA DETTLOFF
14214 MORAVIAN MANOR CIR
STERLING HEIGHTS, MI 48312-5796
Phone number:
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