Individual
MR. CHARLES REGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
600 FORT ST, SUITE 100, PORT HURON, MI 48060-3941
(810) 987-9871
(810) 987-6070
Mailing address
600 FORT ST, SUITE 100, PORT HURON, MI 48060-3941
(810) 987-9871
(810) 987-6070
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
—
—
363A00000X
Physician Assistant
Primary
5601005151
MI
Other
Enumeration date
04/18/2006
Last updated
02/29/2012
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