Individual
GERALDINE CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14460 ROSS LAKE ROAD, SENEY, MI 49883
(906) 202-1898
Mailing address
PO BOX 38, SENEY, MI 49883-0038
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501003960
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650G710060
BLUE CROSS BLUE SHIELD MI
MI
Enumeration date
07/24/2006
Last updated
06/18/2008
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