Organization
BRAINSPAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE SHAWVER (ADMINISTRATIVE DIRECTOR)
(419) 469-0636
Entity
Organization
Contact information
Practice address
5301 MCAULEY DR, YPSILANTI, MI 48197-1051
(734) 712-3456
Mailing address
2415 UNDERHILL RD, OTTAWA HILLS, OH 43615-2331
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
—
—
2084V0102X
Vascular Neurology Physician
Primary
—
—
Other
Enumeration date
08/20/2021
Last updated
08/20/2021
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