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1962905596
ETHAN JOSEPH BOOMS
SAGINAW, MI
NPI
1962905596
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: MI 5201009403)
Enumeration Date
2018-03-09
Last Update Date
2018-06-16
Business Address
ETHAN JOSEPH BOOMS OTRL
1447 N HARRISON ST
SAGINAW, MI 48602-4727
Phone number: 989-583-6387
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Mailing Address
ETHAN JOSEPH BOOMS OTRL
600 IRVING AVE
SAGINAW, MI 48602-5375
Phone number: 989-583-6387
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