Provider Information for 1073102711
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Ms. B MICHELLE ARCHER
Sex: Female
NPI: 1073102711
Last Updated: 2024-08-07
Certification Date: 2024-08-07
Certification Date: 2024-08-07
Details
| Name | Value | ||||||||||||
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| NPI | 1073102711 | ||||||||||||
| Enumeration Date | 2021-01-17 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | YES | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 828 SW PALM CITY RD STUART, FL 34994-2820 United States Phone: 724-491-8010 | Fax: | ||||||||||||
| Primary Practice Address | 828 SW PALM CITY RD STUART, FL 34994-2820 United States Phone: 724-491-8010 | Fax: | ||||||||||||
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