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1477058394
MIA KORINNE ROETHERFORD
DETROIT, MI
NPI
1477058394
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
174N00000X Lactation Consultant, Non-RN
(Licence: MI L112282)
Enumeration Date
2018-03-25
Last Update Date
2018-03-25
Business Address
MIA KORINNE ROETHERFORD
18697 SUNDERLAND RD
DETROIT, MI 48219-2816
Phone number: 313-587-0497
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Mailing Address
MIA KORINNE ROETHERFORD
18697 SUNDERLAND RD
DETROIT, MI 48219-2816
Phone number: 313-587-0497
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