Individual
EMILY FAIRCHILD BONISTEEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
6815 NORVELL RD, BROOKLYN, MI 49230-9531
(734) 709-2924
Mailing address
6815 NORVELL RD, BROOKLYN, MI 49230-9531
(734) 709-2924
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703105617
MI
Other
Enumeration date
04/10/2015
Last updated
04/10/2015
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