Individual
DAVID SOMERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12 KINGSLEY CT, FRANKENMUTH, MI 48734-1270
(989) 652-4252
Mailing address
255 MAYER RD APT M252, FRANKENMUTH, MI 48734-2007
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501008740
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650G312140
BLUE CROSS BLUE SHIELD MI
MI
01
—
DD5657
RAILROAD
MI
Enumeration date
08/01/2006
Last updated
05/27/2010
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