ANGELO SO ANTARAN

YPSILANTI, MI
NPI1932106481
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: MI  5601003519)
Enumeration Date2005-06-30
Last Update Date2007-07-09
Business Address
-- ANGELO SO ANTARAN PA
5301 E HURON RIVER DR
YPSILANTI, MI 48197-1051
Phone number: 734-712-5609
Mailing Address
-- ANGELO SO ANTARAN PA
5301 E HURON RIVER DR
YPSILANTI, MI 48197-1051
Phone number: 734-712-5609
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