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General NPI Number Information
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NPI Number | 1285488718
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Entity Type | Individual
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Provider Name | MRS. JUANITA LLOYD-MINKUS
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Gender | Female
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Dates
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Enumeration Date | 04/12/2024
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Last Update Date | 04/12/2024
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Provider Practice Location Address
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Address Line | 9722 5 MILE RD
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City | LAKEVIEW
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State | MI
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Zip | 48850-9643
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Country | US
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Telephone | 231-598-1990
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 206
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City | MECOSTA
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State | MI
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Zip | 49332-0206
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Country | US
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Telephone | 231-598-1990
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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