Individual
MRS. MICHELLE K DU LAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
113 LIELMANIS AVE, HURLBURT FIELD, FL 32544-5613
(850) 881-2198
Mailing address
16 MAGNOLIA AVE, SHALIMAR, FL 32579-1110
(850) 881-2198
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
07/21/2009
Last updated
07/21/2009
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