MEDICARE: NANCY LILLIE STROSTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	246Z00000X	Other Specialist/Technologist		MI

General Provider Information

NPI Number	:	1356733976
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY LILLIE STROSTER

Provider Business Mailing Address
First Line	:	6950 LONG AVE
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-1286
Country	:	US
Telephone Number	:	248-722-3993
Fax Number	:

Provider Business Practice Location Address
First Line	:	6950 LONG AVE
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-1286
Country	:	US
Telephone Number	:	248-722-3993
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/19/2015
Last Update Date	:	02/19/2015

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Directions to “ NANCY LILLIE STROSTER ” Practice Location

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