Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 175L00000X | Homeopath |
NPI | 1104067982 |
---|---|
Provider Name | Ms. Jewell Lezell Mcghee |
First Address | Livonia, MI 48151-6851 |
Second Address | Redford, MI 48239-1416 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2009 |
Last Update Date | 09/03/2009 |