Organization
CARD PROP CORP
Active
Organization
CARD PROP CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY BASTOW D.O. (PRESIDEN)
(269) 637-1388
Entity
Organization
Contact information
Practice address
950 BLUE STAR HWY, SUITE 1-2, SOUTH HAVEN, MI 49090-7759
(269) 637-1388
(269) 637-1459
Mailing address
950 BLUE STAR HWY, SUITE 1-2, SOUTH HAVEN, MI 49090-7759
(269) 637-1388
(269) 637-1459
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
5101008849
MI
Other
Enumeration date
12/19/2011
Last updated
06/08/2012
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