Individual
EDWARD VELASCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 NORTH ST W, TAWAS CITY, MI 48763-9161
(989) 362-8647
Mailing address
4630 MCNICHOL AVE, OSCODA, MI 48750-1512
(989) 739-3722
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3501011383
MI
Other
Enumeration date
11/27/2013
Last updated
11/27/2013
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