Individual
MARI I DEBOLT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
1934415
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1934415
EMERGENCY MEDICAL TECHNICIAN LICENSE
MI
Enumeration date
06/18/2019
Last updated
06/18/2019
Update your record
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