Individual
DR. RONALD A HYDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHIROPRACTOR
Contact information
Practice address
15418 BREST ST, SOUTHGATE, MI 48195-2207
(734) 552-2074
Mailing address
PO BOX 1933, SOUTHGATE, MI 48195-0933
(734) 552-2074
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
RH005423
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95OH25272
BLUE CROSS PROVIDER #
MI
Enumeration date
03/21/2007
Last updated
07/08/2007
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