Individual
MIKE BAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5161 CARDINAL PARK DRIVE, SAGINAW, MI 48604-9435
(989) 797-2400
(989) 249-1035
Mailing address
PO BOX 5649, SAGINAW, MI 48603-0649
(989) 797-2400
(989) 249-1035
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
MB000027
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4296145
—
MI
01
—
MB000027
STATE LICENCE
MI
Enumeration date
11/06/2006
Last updated
04/11/2011
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