Individual
JEREMIAH J VALLENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
7560 MOORISH RD, BRIDGEPORT, MI 48722-9769
(989) 355-5944
Mailing address
7560 MOORISH RD, BRIDGEPORT, MI 48722-9769
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703103784
MI
Other
Enumeration date
05/15/2019
Last updated
05/15/2019
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