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Individual

MRS. AMY MARIE FOMIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
39205 COUNTRY CLUB DR STE C26, FARMINGTON HILLS, MI 48331-5718
(248) 365-6109
Mailing address
39205 COUNTRY CLUB DR STE C26, FARMINGTON HILLS, MI 48331-5718
(248) 365-6109

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704201285
MI

Other

Enumeration date
10/01/2020
Last updated
12/18/2023
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