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Organization

TOWNSHIP OF BLAIR

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. PATRICK PAHL (TOWNSHIP SUPERVISOR)
(231) 276-9263
Entity
Organization

Contact information

Practice address
2121 CO RD 633, GRAWN, MI 49637-9406
(231) 276-9263
Mailing address
2121 CO RD 633, GRAWN, MI 49637-9406
(231) 276-9263

Taxonomy

Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
281004
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3106667
MI
01
590B800060
BLUE CROSS BLUE SHIELD
MI
Enumeration date
11/02/2006
Last updated
02/29/2012
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