Individual
BETHANY LAROSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12165 COUNTRY RUN DR, BIRCH RUN, MI 48415-8535
(989) 928-7093
Mailing address
12165 COUNTRY RUN DR, BIRCH RUN, MI 48415-8535
(989) 928-7093
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/04/2025
Last updated
02/04/2025
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