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1992370118
ETHAN DAWSON-BAGLIEN
EAST LANSING, MI
NPI
1992370118
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: MI 5151015135)
Enumeration Date
2021-05-20
Last Update Date
2021-08-08
Business Address
ETHAN DAWSON-BAGLIEN DO
965 WILSON RD RM A233
EAST LANSING, MI 48824-6410
Phone number: 517-353-4362
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Mailing Address
ETHAN DAWSON-BAGLIEN DO
965 WILSON RD RM A233
EAST LANSING, MI 48824-6410
Phone number: 517-614-6138
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