Individual
KYLE WILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1215 E MICHIGAN AVE, LANSING, MI 48912-1811
(517) 364-1000
Mailing address
2375 CLUB MERIDIAN DR, APT B-12, OKEMOS, MI 48864-4520
(810) 887-1598
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704278897
MI
Other
Enumeration date
05/19/2015
Last updated
05/19/2015
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