Individual
THEODORE RIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
U
Contact information
Practice address
37303 CAMELLIA LN, CLINTON TWP, MI 48036-2019
(734) 645-9243
Mailing address
37303 CAMELLIA LN, CLINTON TWP, MI 48036-2019
(734) 645-9243
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
R360792098308
MI
Other
Enumeration date
10/28/2024
Last updated
10/28/2024
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