Individual
ELISA PAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 LAURENCE AVE, JACKSON, MI 49202-2979
(517) 782-4717
Mailing address
9967 W KL AVE, KALAMAZOO, MI 49009-7905
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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