Organization
MICHIANA SPINE, SPORTS & OCCUPATIONAL REHAB, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN G DREW MD (OWNER)
(574) 252-4150
Entity
Organization
Contact information
Practice address
2500 NILES RD STE 3, SAINT JOSEPH, MI 49085-3225
(574) 252-4150
(574) 252-4159
Mailing address
3740 EDISON LAKES PKWY, MISHAWAKA, IN 46545-3474
(574) 252-4150
(574) 252-4159
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
4301070312
MI
Other
Enumeration date
05/07/2012
Last updated
11/03/2022
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