Individual
MARY FUNDARO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4345 CROOKS RD, UNIT 4, ROYAL OAK, MI 48073-1971
(586) 980-1148
Mailing address
4345 CROOKS RD, UNIT 4, ROYAL OAK, MI 48073-1971
(586) 980-1148
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703110598
MI
Other
Enumeration date
03/18/2014
Last updated
03/18/2014
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