Healthcare Provider Details

I. General information

NPI: 1043491509
Provider Name (Legal Business Name): ALICIA J. FRANCO-IMPERIAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2007
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2241 S LINDEN RD SUITE B
FLINT MI
48532-5458
US

IV. Provider business mailing address

2241 S LINDEN RD STE. B
FLINT MI
48532-5458
US

V. Phone/Fax

Practice location:
  • Phone: 810-733-9470
  • Fax:
Mailing address:
  • Phone: 810-733-9470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301043430
License Number StateMI

VIII. Authorized Official

Name: MRS. CARRIE JEAN CIAK
Title or Position: OFFICE MANGAER/BILLER
Credential:
Phone: 810-733-9470