Individual
TARA MACHLEIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3930 DEXTER TRL, STOCKBRIDGE, MI 49285-9470
(330) 415-4983
Mailing address
3930 DEXTER TRL, STOCKBRIDGE, MI 49285-9470
(330) 416-4983
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703110627
MI
Other
Enumeration date
05/26/2015
Last updated
05/26/2015
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