Individual
MR. BRAD DAVID KEGEBEIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
242 PARK GREEN DR, LAKE ORION, MI 48362-3375
(248) 417-8919
Mailing address
242 PARK GREEN DR, LAKE ORION, MI 48362-3375
(248) 417-8919
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501010102
MI
Other
Enumeration date
09/30/2021
Last updated
09/30/2021
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