Individual
JUSTIN SLATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8512 KILLY, NEWPORT, MI 48166-9492
(734) 512-3679
Mailing address
8512 KILLY, NEWPORT, MI 48166-9492
(734) 512-3679
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
506153
MI
227900000X
Registered Respiratory Therapist
Primary
4401006508
MI
Other
Enumeration date
12/01/2021
Last updated
12/01/2021
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