Individual
REBECCA BAUSTERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
102 N ADELAIDE ST, FENTON, MI 48430-2670
(810) 629-2245
Mailing address
102 N ADELAIDE ST, FENTON, MI 48430-2670
(810) 629-2245
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703087406
MI
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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