Individual
MICHELLE RENEE STORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
20921 HAULOVER CV. #F6, LUTZ, FL 33558
(813) 312-5399
Mailing address
20921 HAULOVER CV. #F6, LUTZ, FL 33558
(813) 312-5399
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PN5202601
FL
Other
Enumeration date
03/24/2016
Last updated
03/24/2016
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