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1891091773
NICOLE THEODORA PETTWAY
DETROIT, MI
NPI
1891091773
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: MI 4703101683)
Enumeration Date
2011-02-10
Last Update Date
2011-02-10
Business Address
-- NICOLE THEODORA PETTWAY lpn
20201 ASBURY PARK ST
DETROIT, MI 48235
Phone number: 313-826-4449
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Mailing Address
-- NICOLE THEODORA PETTWAY lpn
20201 ASBURY PARK
DETROIT, MI 48235-2102
Phone number: 313-826-4449
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