Individual
CHERIE BANTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2324 10TH ST, PORT HURON, MI 48060-6541
(810) 858-3647
Mailing address
2324 10TH ST, PORT HURON, MI 48060-6541
(810) 858-3647
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703097732
MI
Other
Enumeration date
01/22/2015
Last updated
01/22/2015
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