Marrisa Modell
Student in an Organized Health Care Education/Training Program in Canton, MI. Individual provider (NPI-1).
NPI number1942016506
StatusActive
Last updated in NPPESDec 9, 2024
Details
- NPI
- 1942016506
- Entity type
- Individual (NPI-1)
- Name
- Marrisa Modell
- Sole proprietor
- No
- Enumeration date
- Dec 9, 2024
- Certification date
- Dec 8, 2024
- Last updated
- Dec 9, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
43825 Michigan AveCanton, MI 48188-2551
Phone 734-397-3088 · Fax 734-397-0078
Mailing address
10958 Oak Ln Apt 6216Van Buren Township, MI 48111-4377
Phone 734-720-2933
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All 68 Student in an Organized Health Care Education/Training Program providers in Canton · All 2,409 providers in Canton
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