Registry details
Type
Individual
Primary specialty
Internal Medicine
Enumerated
Mar 15, 2006
License(s)
4301078329 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 1540 LAKE LANSING RD STE 102 | Lansing, MI 48912-3757 | 517-913-3810 |
| LOCATION | 1540 LAKE LANSING RD STE 102 | Lansing, MI 48912-3757 | 517-913-3810 |
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