Mylaica Conner

NPI #1104202035 in Wayne, Michigan

Provider Information

NPI Number: 1104202035
Entity Type: Individual
Name: Mylaica Conner
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician, Other
Enumeration Date: Aug 3, 2015
Last Updated: Aug 3, 2015

Practice Location

Address: 35640 W MICHIGAN AVE
City: Wayne
State: Michigan
ZIP Code: 48184-1628
Phone: (734) 729-7792

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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