Individual
BETH H. REVARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RT
Contact information
Practice address
38878 POLO CLUB DR, APT #102, FARMINGTON HILLS, MI 48335-5612
(248) 790-3920
Mailing address
38878 POLO CLUB DR, APT #102, FARMINGTON HILLS, MI 48335-5612
(248) 790-3920
Taxonomy
Speciality
Code
Description
License number
State
2471C3401X
Computed Tomography Radiologic Technologist
Primary
186511
MI
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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