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Individual

SAUNDRA K AVERY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN, LMT

Contact information

Practice address
8399 HOLLY DR, CANTON, MI 48187-4237
(734) 218-0505
Mailing address
8399 HOLLY DR, CANTON, MI 48187-4237
(734) 218-0505

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
4703113427
MI
225700000X
Massage Therapist
Primary
7501000228
MI

Other

Enumeration date
02/26/2019
Last updated
02/26/2019
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