Registry details
Type
Individual
Primary specialty
Nurse Practitioner
Enumerated
Oct 24, 2016
License(s)
4704281589 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1325 S LINDEN RD | Flint, MI 48532-3408 | 810-535-5555 |
| MAILING | 23754 MANILA ST | Clinton Township, MI 48035-3840 | 586-883-1599 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.