Individual
MICHAEL ROBERT BLOSTICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
23332 RED ARROW HWY, MATTAWAN, MI 49071-9703
(269) 283-5673
Mailing address
24395 BROWNSTONE BLVD, MATTAWAN, MI 49071-7815
(269) 377-0892
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009116
MI
Other
Enumeration date
07/19/2019
Last updated
07/19/2019
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