Elise Miriam Averitt

NPI #1265872733 in Portage, Michigan

Provider Information

NPI Number
1265872733
Entity Type
Individual
Name
Elise Miriam Averitt
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Technician, Other
Enumeration Date
Jun 28, 2013
Last Updated
Jun 28, 2013

Practice Location

Address
9616 PORTAGE RD
ZIP Code
49002-7257
Phone
(269) 250-8200

Specialties & Taxonomy Codes

Specialty
Technician, Other

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