Individual
MICHAEL DAVID FETTERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3111 ELECTRIC AVE, PORT HURON, MI 48060-8127
(810) 985-8900
Mailing address
3177 ELK ST, PORT HURON, MI 48060-2074
(810) 300-6153
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
04/16/2022
Last updated
04/16/2022
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