Organization
MICHIGAN STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA RUCKER (ENROLLMENT & PATIENT ACCTS MANAGER)
(517) 884-2976
Entity
Organization
Contact information
Practice address
1355 BOGUE ST RM B228, EAST LANSING, MI 48824-6207
(517) 355-4616
(517) 353-5436
Mailing address
1355 BOGUE STREET, ROOM B228, EAST LANSING, MI 48824-6239
(517) 355-4616
(517) 353-5436
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
23D0650872
MI
Other
Enumeration date
04/09/2009
Last updated
04/05/2018
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