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Individual

JUSTINE NICA MORIARTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
IDHS

Contact information

Practice address
650 S HARBOR DR, GRAND HAVEN, MI 49417-1742
(616) 850-2520
(616) 850-2521
Mailing address
650 S HARBOR DR, GRAND HAVEN, MI 49417-1742
(616) 850-2520
(616) 850-2521

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
09/23/2021
Last updated
09/23/2021
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