Individual
BRIDGETTE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3940 STATE RD, FORT GRATIOT, MI 48059-4061
(810) 300-6885
Mailing address
3940 STATE RD, FORT GRATIOT, MI 48059-4061
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703113131
MI
Other
Enumeration date
06/16/2016
Last updated
06/16/2016
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