Individual
MS. LORI MIZWICKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3232 KERLIKOWSKE RD, COLOMA, MI 49038-8969
(269) 208-3653
Mailing address
3232 KERLIKOWSKE RD, COLOMA, MI 49038-8969
(269) 208-3653
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202003449
MI
Other
Enumeration date
11/01/2022
Last updated
11/01/2022
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