Individual
MARY REBECCA STOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
3950 SHORE DR, WILLIAMSBURG, MI 49690-9548
(231) 938-7004
Mailing address
3950 SHORE DR, WILLIAMSBURG, MI 49690-9548
(231) 938-7004
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
L1397712
MI
Other
Enumeration date
09/03/2008
Last updated
11/08/2011
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