Organization
VISITING HOME MD
Active
Organization
VISITING HOME MD
Active
Other names
Physical Medicine and Rehabilitation Specialists of Michigan
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JUVENAL LIPANA CASTILLO MD (MANAGING MEMBER)
(269) 350-8463
Entity
Organization
Contact information
Practice address
4239 ISABELLE ST, PORTAGE, MI 49024-1770
(269) 350-8463
(269) 382-4808
Mailing address
9245 AUSTIN DR, PORTAGE, MI 49002-6403
(917) 816-4427
(269) 382-4808
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301087182
MI
208D00000X
General Practice Physician
4301087182
MI
Other
Enumeration date
02/24/2009
Last updated
02/25/2010
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