Individual
LORISA BEARUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
209 S SHIAWASSEE ST, CORUNNA, MI 48817-1639
(941) 894-5581
Mailing address
209 S SHIAWASSEE ST, CORUNNA, MI 48817-1639
(941) 894-5581
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501009857
MI
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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