Individual
MARY FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
416 CONNABLE AVE, PETOSKEY, MI 49770-2212
(800) 248-6777
Mailing address
416 CONNABLE AVE, PETOSKEY, MI 49770-2212
(800) 248-6777
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201002439
MI
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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