Valerie Kassuba
Technician/Technologist, Optician in Gaylord, MI. Individual provider (NPI-1).
NPI number1114756756
StatusActive
Last updated in NPPESJul 31, 2024
Details
- NPI
- 1114756756
- Entity type
- Individual (NPI-1)
- Name
- Valerie Kassuba
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 31, 2024
- Certification date
- Jul 31, 2024
- Last updated
- Jul 31, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | 228189 | MI | Yes |
Practice location
950 Edelweiss Village PkwyGaylord, MI 49735-7441
Phone 989-732-5233
Mailing address
Po Box 374Johannesburg, MI 49751-0374
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