Individual
BRENDA JEAN CLANTON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1324 HICKORY ST, NILES, MI 49120-3620
(269) 687-9279
Mailing address
1324 HICKORY ST, NILES, MI 49120-3620
(269) 687-9279
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27020391A
IN
Other
Enumeration date
03/08/2006
Last updated
07/08/2007
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