Individual
MRS. MARYALICE ADAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAIR LOSS SPT.
Contact information
Practice address
152 LAKE AVE, BENTON HARBOR, MI 49022-4620
(269) 325-1001
(269) 925-8030
Mailing address
152 LAKE AVE, BENTON HARBOR, MI 49022-4620
(269) 325-1001
(269) 925-8030
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
03/11/2019
Last updated
03/11/2019
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