Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL DETRISAC
Active Sole Proprietor2472E0500X · ANN ARBOR, MI
Registration Details
- NPI Number
- 1053689836
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 7, 2011 (14.372607575549 yrs)
- Last Updated
- Dec 7, 2011
- Sole Proprietor
- Yes
Practice Information
- Address
-
812 AVIS DRANN ARBOR, MI, 481089649Browse MI providers · Browse ZIP 48108
- Phone
- 7346223920
- Primary Specialty
-
2472E0500X
2472E0500X
Other 2472E0500X Providers in ANN ARBOR, MI
| Name | Credential | NPI |
|---|---|---|
| TYLER JAMES HANAK | CNIM | 1740554872 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.