Individual
MISTEY CARROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
704 EMMET ST, PETOSKEY, MI 49770-2910
(231) 347-5511
Mailing address
704 EMMET ST, PETOSKEY, MI 49770-2910
(231) 347-5511
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
02/08/2024
Last updated
02/08/2024
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