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Individual

MRS. CAROLYN MARIE RICHARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
7470 BROCKWAY RD, BROCKWAY, MI 48097-3458
(810) 387-9355
Mailing address
7696 METCALF RD, GREENWOOD, MI 48006-2726
(810) 387-9355

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601003614
MI

Other

Enumeration date
09/25/2006
Last updated
07/08/2007
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