Ann Bernita Fedewa

NPI #1053165803 in Portland, Michigan

Provider Information

NPI Number: 1053165803
Entity Type: Individual
Name: Ann Bernita Fedewa
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Chore Provider
Enumeration Date: Apr 16, 2024
Last Updated: Apr 16, 2024

Practice Location

Address: 231 GRAPE ST
City: Portland
State: Michigan
ZIP Code: 48875-1132
Phone: (517) 755-9040

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chore Provider	372500000X	Primary

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