Individual
SARA LYNNE BLASIUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
743 WALNUT ST, CHARLOTTE, MI 48813-1737
(517) 898-6913
Mailing address
743 WALNUT ST, CHARLOTTE, MI 48813-1737
(517) 898-6913
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
B422758564613
MI
Other
Enumeration date
04/01/2024
Last updated
04/01/2024
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