Individual
CHARLETTE LEGION-LONDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
41521 W 11 MILE RD # RF, NOVI, MI 48375-1803
(248) 299-0300
Mailing address
24981 DORIS CT, REDFORD, MI 48239
(313) 578-1381
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703087516
MI
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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