MR. Blaine Bishop

NPI #1124572169 in Grosse Pointe Park, Michigan

Provider Information

NPI Number: 1124572169
Entity Type: Individual
Name: MR. Blaine Bishop
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Aug 8, 2016
Last Updated: Aug 8, 2016

Practice Location

Address: 1136 THREE MILE DR
City: Grosse Pointe Park
State: Michigan
ZIP Code: 48230-1415
Phone: (313) 600-0144

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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