Individual
MICHELLE DENISE BAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
710 KIOWA LN, BROKEN BOW, NE 68822-2733
(308) 872-6415
Mailing address
710 KIOWA LN, BROKEN BOW, NE 68822-2733
(308) 872-6415
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
12/31/2024
Last updated
01/08/2025
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