Ireneusz Bak
Home Health Aide in Warren, MI. Individual provider (NPI-1).
NPI number1083079024
StatusActive
Last updated in NPPESDec 17, 2015
Details
- NPI
- 1083079024
- Entity type
- Individual (NPI-1)
- Name
- Ireneusz Bak
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Dec 17, 2015
- Last updated
- Dec 17, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374U00000X | Home Health Aide | B200343005123 | MI | Yes |
Practice location
27200 Baldwin AveWarren, MI 48092-2782
Phone 586-344-4495
Mailing address
27200 Baldwin AveWarren, MI 48092-2782
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