Michael Detrisac

NPI #1053689836 in Ann Arbor, Michigan

Provider Information

NPI Number: 1053689836
Entity Type: Individual
Name: Michael Detrisac
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician, Other - EEG
Enumeration Date: Dec 7, 2011
Last Updated: Dec 7, 2011

Practice Location

Address: 812 AVIS DR
City: Ann Arbor
State: Michigan
ZIP Code: 48108-9649
Phone: (734) 622-3920

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other - EEG — EEG	2472E0500X	Primary

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