Individual
LA'SHON THEDFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
62 NORTHBOUND GRATIOT AVE, MOUNT CLEMENS, MI 48043-2310
(586) 468-8983
Mailing address
62 NORTHBOUND GRATIOT AVE, MOUNT CLEMENS, MI 48043-2310
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
4703104399
MI
Other
Enumeration date
11/12/2014
Last updated
11/13/2014
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