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Individual

MATTHEW WEBER AUSTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1500 S MAIN ST, EATON RAPIDS, MI 48827-1952
(517) 663-9483
Mailing address
6502 DARBY RD, SARANAC, MI 48881-9696
(616) 915-3169

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
6401016699
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6401016699
MI
Enumeration date
06/19/2018
Last updated
06/19/2018
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