Stacey Junior

NPI #1962874156 in River Rouge, Michigan

Provider Information

NPI Number: 1962874156
Entity Type: Individual
Name: Stacey Junior
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Chore Provider
Enumeration Date: Oct 27, 2015
Last Updated: Oct 27, 2015

Practice Location

Address: 94 E HENRY ST
City: River Rouge
State: Michigan
ZIP Code: 48218-1640
Phone: (313) 300-9711

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chore Provider	372500000X	Primary

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