Organization
SUPPORTIVE CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS BRANDI DANIELLE WATTERS PRACTICAL NURSE (OWNER)
(586) 252-6974
Entity
Organization
Contact information
Practice address
14823 E 12 MILE RD, WARREN, MI 48088-4004
(586) 252-6974
Mailing address
14823 E 12 MILE RD, WARREN, MI 48088-4004
(586) 252-6974
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
—
—
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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