IndividualActive
An Ly
NPI 1740553700 · Specialist · Sterling Heights, MI
Provider details
- NPI number
- 1740553700
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- D5476V (MI)
Specialties & taxonomies
Other Service Providers
Other Service Providers
Other Service Providers
Practice location
33162 Dequindre Rd
Sterling Heights, MI 48310-5915
Phone: (586) 977-0202
Fax: (586) 977-6688
Approximate (ZIP-level) locationGet directions
Mailing address
33162 Dequindre Rd
Sterling Heights, MI 48310-5915
Registry dates
- Enumerated
- 2012-02-21
- Last updated
- 2012-02-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.