Individual
KAITLYN HALEY BACKING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
845 S LAPEER RD, LAKE ORION, MI 48362-2925
(248) 469-0011
(248) 621-4327
Mailing address
1170 FOX CT, OXFORD, MI 48371-5968
(248) 881-3483
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601008071
MI
Other
Enumeration date
04/22/2017
Last updated
10/31/2023
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