Individual provider · Type 1 NPI

Michael Detrisac

EEG Technician · Ann Arbor, MI

NPI number 1053689836 Active

Practice location

812 Avis Dr
Ann Arbor, MI 48108-9649

Call (734) 622-3920 Map

Mailing address

PO Box 104
Niles, MI 49120-0104

Specialties and licenses

TaxonomyCodeLicense
EEG Technician Primary 2472E0500XNone listed

EEG Technician: Definition to come...

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About NPI 1053689836

Michael Detrisac's National Provider Identifier is 1053689836, issued on Dec 7, 2011. The primary taxonomy on file is EEG Technician (2472E0500X), and the practice location is in Ann Arbor, MI. The record was last updated on Dec 7, 2011.