Individual
MRS. CARRIE LYNN DEXTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9200 W WALKER RD, MANTON, MI 49663-9315
(231) 878-8352
Mailing address
9200 W WALKER RD, MANTON, MI 49663-9315
(231) 878-3914
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
10/30/2018
Last updated
10/30/2018
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