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1942968540
BRIAN DOMINIC
BOYNE FALLS, MI
NPI
1942968540
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
Enumeration Date
2021-12-01
Last Update Date
2021-12-01
Business Address
BRIAN DOMINIC CADC-DP
2594 SPRINGVALE RD
BOYNE FALLS, MI 49713-9684
Phone number: 231-535-2822
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Mailing Address
BRIAN DOMINIC CADC-DP
2329 CENTER ST
BOYNE FALLS, MI 49713-9268
Phone number: 231-535-2822
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