Individual
LISA STOCKWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
427 PEARL ST, MARINE CITY, MI 48039-3472
(810) 533-8185
Mailing address
427 PEARL ST, MARINE CITY, MI 48039-3472
(810) 533-8185
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703081718
MI
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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