Provider Information for 1982944518
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Mrs. SUSIE HARTZ BA
Sex: Female
NPI: 1982944518
Last Updated: 2021-08-17
Certification Date: 2021-08-17
Certification Date: 2021-08-17
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1982944518 | ||||||||
| Enumeration Date | 2013-02-19 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 336 E 4TH ST GAYLORD, MI 49735-1235 United States Phone: 989-619-9333 | Fax: | ||||||||
| Primary Practice Address | 111 S COURT AVE STE 100 GAYLORD, MI 49735-1351 United States Phone: 989-619-9333 | Fax: | ||||||||
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