Individual
MR. MICHAEL CONSTANCIO RESPICIO MAHINAY IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
1250 MAIN ST, #1282, MOUNT VERNON, IN 47620
(812) 549-6512
Mailing address
3325 YALE DR, EVANSVILLE, IN 47711-7305
(812) 549-6512
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
05009818A
IN
Other
Enumeration date
06/29/2007
Last updated
12/08/2016
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