Samantha Dutra

NPI #1104274018 in Birch Run, Michigan

Provider Information

NPI Number: 1104274018
Entity Type: Individual
Name: Samantha Dutra
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Jun 1, 2016
Last Updated: Jun 1, 2016

Practice Location

Address: 11908 SILVER CREEK DR APT 11
City: Birch Run
State: Michigan
ZIP Code: 48415-9755
Phone: (989) 293-2473

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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