Individual
JULIANNE FOX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8191 MOORSBRIDGE RD, PORTAGE, MI 49024-7416
(269) 312-8170
Mailing address
710 FLAMINGO AVE, PORTAGE, MI 49024-2712
(269) 271-4113
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704257196
MI
Other
Enumeration date
04/03/2017
Last updated
04/03/2017
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