Individual
ERIC BENTLAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
580 W COLLEGE AVE, MARQUETTE, MI 49855-2705
(906) 228-9440
Mailing address
170 BAYOU ST, MARQUETTE, MI 49855-9101
(248) 515-0647
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704263932
MI
Other
Enumeration date
01/12/2012
Last updated
01/12/2012
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