Individual
REBECCA BRANCHEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1125 E MILHAM AVE, SUITE C, PORTAGE, MI 49002-3096
(269) 220-5033
Mailing address
1125 E MILHAM AVE, SUITE C, PORTAGE, MI 49002-3096
(269) 220-5033
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
7501004536
MI
Other
Enumeration date
06/08/2016
Last updated
04/25/2017
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