Individual
MELISSA MARIE BENTLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1180 E VIENNA RD, CLIO, MI 48420-1835
(810) 686-4858
Mailing address
2099 W WILSON RD, CLIO, MI 48420-1603
(810) 686-4858
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3183405
—
MI
Enumeration date
05/10/2007
Last updated
07/09/2007
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