Individual
MICHELLE REAVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2053 JEANNIE CT, WARREN, MI 48091-5136
(586) 596-3436
Mailing address
2053 JEANNIE CT, WARREN, MI 48091-5136
(586) 596-3436
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703110076
MI
Other
Enumeration date
04/19/2016
Last updated
04/19/2016
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