Individual
KYLE VIRES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2271 GEYER CT, LAKE ORION, MI 48360
(586) 215-7044
Mailing address
2271 GEYER CT, LAKE ORION, MI 48360
(586) 215-7044
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4704308076
MI
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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