Individual
MRS. MARY KAY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
2878 RIVER MEADOW CIR, CANTON, MI 48188-2333
(734) 645-7952
Mailing address
2878 RIVER MEADOW CIR, CANTON, MI 48188-2333
(734) 645-7952
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704239518
MI
Other
Enumeration date
09/09/2013
Last updated
09/09/2013
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