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Individual

MRS. LIANE MARIE FORMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1 FORD PL, DETROIT, MI 48202-3450
(313) 401-5099
Mailing address
1 FORD PL, DETROIT, MI 48202-3450

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704338860
MI

Other

Enumeration date
04/06/2026
Last updated
04/06/2026
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