Registry details
Type
Individual
Primary specialty
Anesthesiology
Enumerated
Aug 22, 2005
License(s)
4301082970 (MI), 35082201 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 1447 N HARRISON ST | Saginaw, MI 48602-4727 | 989-583-7000 |
| MAILING | 14629 PRAIRIE LAKE DR | Perrysburg, OH 43551 | 419-690-8698 |
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