| NPI | 1952678609 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND BLAINE RAWSON Owner 231-487-5837 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207T00000X Neurological Surgery (Licence: MI 4301086659) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-11-23 |
| Last Update Date | 2017-10-11 |