Individual
BRANDY GODBOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1368 PERRY LAKE RD, ORTONVILLE, MI 48462-9111
(586) 556-6020
Mailing address
1368 PERRY LAKE RD, ORTONVILLE, MI 48462-9111
(586) 556-6020
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704311410
MI
Other
Enumeration date
04/17/2025
Last updated
04/17/2025
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