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Individual

SIEIRA E BACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
25639 FORD RD, DEARBORN HEIGHTS, MI 48127-4817
(313) 277-3293
Mailing address
25844 SHORELINE DR, NOVI, MI 48374-2171
(989) 400-0605

Taxonomy

Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
4704323324
MI

Other

Enumeration date
07/15/2021
Last updated
07/15/2021
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