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Caneisha Danielle Coburn

NPI Registration Record

Provider / OrganizationNPIDate Certified
CANEISHA DANIELLE COBURN14670792362020-06-28
Entity TypeIndividual
Provider Name Caneisha Danielle Coburn
Practice Office Address1234 NAPIER AVE
SAINT JOSEPH, MI US
Practice Office Telephone2699838300
Mailing Address1234 NAPIER AVE
SAINT JOSEPH, MI 490852112 US
Business Telephone2699838300
HPT Codes
CodeLicense NoState
390200000X PRIMARY
OPI Codes

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