Individual
LOIS UMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2131 COURTNEY DR, HARRISON, MI 48625-9050
(989) 418-8477
Mailing address
2131 COURTNEY DR, HARRISON, MI 48625-9050
(989) 418-8477
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
7563003
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02980805
DEPARTMENT OF HUMAN SERVICES
MI
01
—
1004128123
ROBERT TOWNSEND
MI
01
—
28932020
ANDREW ROACH
MI
Enumeration date
10/06/2015
Last updated
10/06/2015
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