Individual
CHIQUETA M MCDONALD-MOORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
536 ROMENCE RD STE 106, PORTAGE, MI 49024-3437
(616) 366-1889
Mailing address
536 ROMENCE RD STE 106, PORTAGE, MI 49024-3437
(616) 366-1889
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
27701166199
MI
Other
Enumeration date
06/22/2024
Last updated
06/22/2024
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