Individual
ANDREW CURTIS HAVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT, ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501015439
MI
2255A2300X
Athletic Trainer
2601000393
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30435
BCBS OF MICHIGAN
MI
Enumeration date
12/09/2010
Last updated
12/09/2010
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