Individual
JUDITH TABACZKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
535 1ST ST, MANISTEE, MI 49660-1569
(231) 723-5550
Mailing address
535 1ST ST, MANISTEE, MI 49660-1569
(231) 723-5550
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704173975
MI
Other
Enumeration date
04/25/2014
Last updated
04/25/2014
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