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Organization
RANDALL STREET MEDICAL PC
Active
Organization
RANDALL STREET MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROGER HOLMAN D.O. (OWNER/PHYSICIAN)
(616) 837-9777
Entity
Organization
Contact information
Practice address
675 W RANDALL ST, COOPERSVILLE, MI 49404-1305
(616) 837-9777
(616) 837-7813
Mailing address
675 W RANDALL ST, COOPERSVILLE, MI 49404-1305
(616) 837-9777
(616) 837-7813
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
5101006733
MI
Other
Enumeration date
03/14/2006
Last updated
07/22/2008
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