Individual
MS. LEONORA S FORIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
439 S FANCHER ST, MOUNT PLEASANT, MI 48858-2614
(989) 772-9356
Mailing address
439 S FANCHER ST, MT PLEASANT, MI 48858-2614
(989) 772-9356
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
AF370255232
MI
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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