Organization
TREVOR NEAL DPM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA HOLLISTER (FACILITY DIRECTOR)
(269) 651-2320
Entity
Organization
Contact information
Practice address
102 S LAKEVIEW AVE, STURGIS, MI 49091-1947
(269) 651-2320
Mailing address
PO BOX 730, STURGIS, MI 49091-0730
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
TN001392
MI
Other
Enumeration date
05/29/2008
Last updated
06/23/2014
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