Individual
KRYSTLE CHAVEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
716 FIFTH ST, JACKSON, MI 49203-5827
(517) 740-8000
Mailing address
716 FIFTH ST, JACKSON, MI 49203-5827
(517) 740-8000
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703103892
MI
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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