Individual
REBECCA ANN MODDIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
325 E H ST, IRON MOUNTAIN, MI 49801-4760
(906) 774-3300
Mailing address
325 E H ST, IRON MOUNTAIN, MI 49801-4760
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
323415-31
WI
Other
Enumeration date
06/30/2026
Last updated
06/30/2026
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