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Individual

COURTNEY LAJUAN CARMICHAEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
109 PUGH ST, MARTIN, SD 57551-7700
(605) 685-6868
Mailing address
109 PUGH ST, MARTIN, SD 57551-7700

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
08/22/2017
Last updated
08/22/2017
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