Individual
BONNIE LOU PERKINS/CRACKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
116 ROBERTS ST, MANTON, MI 49663-9124
(231) 824-6383
(231) 824-6939
Mailing address
116 ROBERTS ST, MANTON, MI 49663-9124
(231) 824-6383
(231) 824-6939
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
AF830279137
MI
Other
Enumeration date
11/07/2012
Last updated
11/07/2012
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