Individual
LISA MARIE PETZOLD-YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10211 HALSEY RD, GRAND BLANC, MI 48439-8209
(810) 422-4960
Mailing address
10211 HALSEY RD, GRAND BLANC, MI 48439-8209
(810) 422-4960
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5002205694
MI
Other
Enumeration date
09/06/2023
Last updated
09/07/2023
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