NPI | 1518330034 |
---|---|
Former Name | MARY LORAN MAKENZIE GEORGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: MI 2301010430) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: MO 2015013420) |
Enumeration Date | 2015-11-05 |
Last Update Date | 2022-03-25 |