Most Relevant Information
Provider Data
| NPI Number: | 1003441585 |
| Provider Name: | TABITHA SUDBECK |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | TMSH000117 |
Most Important Dates
| Enumeration Date: | 03/05/2020 |
| Last Updated: | 03/05/2020 |
Provider Practice Location
2521 N ELMS RD
FLUSHING
MI
484339423
Practice Location Phone/Fax
| Phone: | 8104875571 |
| Fax: |
Provider Mailing Location
2521 N ELMS RD
FLUSHING
MI
484339423
Provider Mailing Phone/Fax
| Phone: | 8104875571 |
| Fax: |