Individual
MISS SHIRLEY ANN LEE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AFC LICENSEE
Contact information
Practice address
715 E VINE ST, KALAMAZOO, MI 49001-3039
(269) 382-4612
Mailing address
715 E VINE ST, KALAMAZOO, MI 49001-3039
(269) 382-4612
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
—
MI
Other
Enumeration date
05/09/2018
Last updated
05/09/2018
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