Individual
KAILYN STANDIFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6900 YOUNG AVE NE, ROCKFORD, MI 49341-9414
(714) 321-9987
Mailing address
6900 YOUNG AVE NE, ROCKFORD, MI 49341-9414
(714) 321-9987
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
MI
Other
Enumeration date
10/25/2018
Last updated
10/25/2018
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