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Individual

ASHLEY ENDLINE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BA

Contact information

Practice address
1005 3RD ST, BAY CITY, MI 48708-6012
(989) 778-1396
Mailing address
8759 CLINTON MACON RD, CLINTON, MI 49236-9569
(517) 423-7455

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
B635072585339
DRIVER LICENSE
MI
Enumeration date
10/14/2019
Last updated
10/14/2019
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