Individual
BRANDY LONCORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
56 WASHINGTON ST, SPARTA, MI 49345-1322
(616) 432-1052
Mailing address
56 WASHINGTON ST, SPARTA, MI 49345-1322
(616) 432-1052
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703093784
MI
Other
Enumeration date
04/20/2019
Last updated
04/20/2019
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