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Individual

LEANNE M MANCINI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
2500 NILES ROAD, SUITE 1, ST JOSEPH, MI 49085
(269) 429-5000
(269) 429-2598
Mailing address
2500 NILES ROAD, SUITE 1, ST JOSEPH, MI 49085
(269) 429-5000
(269) 429-2598

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101017116
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5315029748
CONTROLLED SUB
MI
Enumeration date
04/06/2007
Last updated
03/07/2023
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