Individual
MICHAEL WHITAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CST
Contact information
Practice address
6459 US HIGHWAY 59 S, MARSHALL, TX 75672-4143
(903) 938-8753
Mailing address
6459 US HIGHWAY 59 S, MARSHALL, TX 75672-4143
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
101436
TX
Other
Enumeration date
12/12/2007
Last updated
12/12/2007
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