Individual provider · NPI-1

Mojtaba Al-Modhafir

Technician, Other · Detroit, MI

NPI number1265988992
StatusActive
Last updated in NPPESSep 1, 2016

Details

NPI
1265988992
Entity type
Individual (NPI-1)
Name
Mojtaba Al-Modhafir
Sex
Male
Sole proprietor
No
Enumeration date
Sep 1, 2016
Last updated
Sep 1, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
247200000X Technician, Other––Yes

Practice location

6807 Woodmont
Detroit, MI 48228-4334

Phone 313-895-6413

Mailing address

6807 Woodmont
Detroit, MI 48228-4334

Phone 313-895-6413

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Other Technician, Other providers in Detroit, MI