Individual
QUINN LEROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
633 COOPER LAKE RD, ISHPEMING, MI 49849-3362
(906) 869-2021
Mailing address
633 COOPER LAKE RD, ISHPEMING, MI 49849-3362
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704340952
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704340952
MI
Other
Enumeration date
07/09/2021
Last updated
09/11/2023
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