Individual
MARCO PONCE-RESENDIZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9270 MARABELLA DR NE, ROCKFORD, MI 49341-7463
(616) 419-6013
Mailing address
9270 MARABELLA DR NE, ROCKFORD, MI 49341-7463
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703119467
MI
Other
Enumeration date
08/30/2023
Last updated
08/30/2023
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