Organization
LAINGSBURG ANESTHESIA SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DELORIS K VANDERHOOF CRNA (OWNER)
(269) 945-2176
Entity
Organization
Contact information
Practice address
7763 DOYLE RD, LAINGSBURG, MI 48848-9791
(269) 945-2176
Mailing address
7763 DOYLE RD, LAINGSBURG, MI 48848-9791
(269) 945-2176
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704141918
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4308703890
BLUE CROSS BLUE SHIELD
MI
Enumeration date
10/12/2007
Last updated
10/12/2007
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