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Individual

MS. SHEREE GENEVIEVE URICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
1304 OSPREY NEST LN, PORT ORANGE, FL 32128-7160
(386) 767-6907
Mailing address
1304 OSPREY NEST LN, PORT ORANGE, FL 32128-7160
(386) 767-6907

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA24116
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
68116796
FL
Enumeration date
12/10/2007
Last updated
12/10/2007
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