Individual
FRASER RAYMOND WORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
4222 WELLINGTON, JACKSON, MI 49201-7182
(517) 796-3024
Mailing address
4222 WELLINGTON, JACKSON, MI 49201-7182
(517) 796-3024
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703093222
MI
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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