Individual
MR. KEITH LAURAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MT
Contact information
Practice address
11339 JEDDO RD, BROCKWAY, MI 48097-2511
(586) 214-1878
Mailing address
11339 JEDDO RD, BROCKWAY, MI 48097-2511
(586) 214-1878
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7501005302
MI
Other
Enumeration date
01/26/2016
Last updated
01/26/2016
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