Organization
GREAT LAKES SPINE SPORTS & PAIN, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BACHU ABRAHAM M.D. (PRESIDENT)
(989) 772-3800
Entity
Organization
Contact information
Practice address
4676 E BROOMFIELD RD STE A, MT PLEASANT, MI 48858-9192
(989) 772-3800
(840) 626-4066
Mailing address
PO BOX 87, CADILLAC, MI 49601-0087
(231) 775-6076
(231) 775-0027
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Enumeration date
08/02/2006
Last updated
10/03/2007
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