Robert D & Cindy L Douglas

NPI #1023287836 in Ravenna, Michigan

Provider Information

NPI Number: 1023287836
Entity Type: Organization
Organization Name: Robert D & Cindy L Douglas
Primary Specialty: Technician/Technologist
Enumeration Date: Feb 26, 2008
Last Updated: Sep 23, 2008

Practice Location

Address: 12412 STAFFORD
City: Ravenna
State: Michigan
ZIP Code: 49451-0307
Phone: (231) 853-6459

Authorized Official

Name: CINDY LEE DOUGLAS
Title: OPTICIAN
Phone: (231) 853-6459

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician/Technologist	156F00000X	Primary

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