Individual
MR. JUSTIN LERAY MAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-BC
Contact information
Practice address
1913 S JEFFERSON ST, BAY CITY, MI 48708-8742
(989) 965-2168
Mailing address
1913 S JEFFERSON ST, BAY CITY, MI 48708-8742
(989) 965-2168
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704292433
MI
Other
Enumeration date
05/11/2018
Last updated
05/11/2018
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