Individual
SHANE DAVIS FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1501 W CHISHOLM ST, ALPENA, MI 49707-1401
(989) 657-9348
Mailing address
7995 US HIGHWAY 23 N, ALPENA, MI 49707-8953
(989) 657-9348
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5601005707
MI
Other
Enumeration date
02/17/2010
Last updated
08/29/2010
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