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Individual

LAURIE GUSTAFSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
36475 FIVE MILE RD, LIVONIA, MI 48154-1971
(734) 655-8943
Mailing address
944 BRIGHTON LAKE RD, BRIGHTON, MI 48116-1729
(810) 923-7008

Taxonomy

Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary

Other

Enumeration date
04/04/2023
Last updated
04/04/2023
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