Organization
PORT HURON HOSPITAL CRNA BILLING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN J LISTON III (CFO)
(810) 989-3704
Entity
Organization
Contact information
Practice address
1221 PINE GROVE AVE, PORT HURON, MI 48060-3511
(952) 442-9770
(952) 442-3620
Mailing address
PO BOX 713248, CINCINNATI, OH 45271-3248
(952) 442-9770
(952) 442-3620
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
06/22/2011
Last updated
06/22/2011
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