Registry details
Type
Individual
Primary specialty
Nurse Practitioner, Family
Enumerated
Jan 5, 2017
License(s)
4704268873 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 130 MILLWOOD ST | Caro, MI 48723-1630 | 989-672-1555 |
| MAILING | 4675 HILL ST | Cass City, MI 48726-1008 | 989-912-6206 |
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.