Individual
SUZANNE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
102 B S. MAIN ST, LAKE CITY, MI 49651
(231) 394-0168
Mailing address
PO BOX 465, LAKE CITY, MI 49651-0465
(231) 394-0168
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501005782
MI
Other
Enumeration date
12/29/2016
Last updated
12/29/2016
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