Individual
LUN MANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1853 R W BERENDS DR SW, WYOMING, MI 49519-4955
(616) 534-9300
Mailing address
116 21ST ST N # TN, BATTLE CREEK, MI 49015-1705
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703124014
MI
Other
Enumeration date
10/12/2023
Last updated
10/12/2023
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