Individual
ANJOU GOLDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
920 DIANA ST, LUDINGTON, MI 49431-1987
(231) 845-6294
Mailing address
920 DIANA ST, LUDINGTON, MI 49431-1987
(231) 845-6294
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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