Individual
CHRISTIAN LIGHT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
129 E RICHARDS RD APT 4, OREGON, WI 53575-1037
(313) 805-1550
Mailing address
129 E RICHARDS RD APT 4, OREGON, WI 53575-1037
(313) 805-1550
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/12/2022
Last updated
01/12/2022
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