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Individual

DONALD LENARD SYLVESTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
A.C.M.T.

Contact information

Practice address
4532 W HOUGHTON LAKE DR, HOUGHTON LAKE, MI 48629-9005
(989) 366-9148
Mailing address
PO BOX 441, ROSCOMMON, MI 48653-0441
(989) 366-9148

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
DIPLOMA
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
584524
ASSOCIATED BODYWORKERS & MASSAGE PROFESSIONALS
MI
Enumeration date
03/05/2012
Last updated
03/05/2012
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