Individual
TIFFANY KNOCKEART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1853 R W BERENDS DR SW, WYOMING, MI 49519-4955
(616) 534-9300
Mailing address
7190 LAKE VISTA DR SW, BYRON CENTER, MI 49315-9040
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703116934
MI
Other
Enumeration date
07/14/2021
Last updated
07/14/2021
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