Pamela Sue Southgate

NPI #1629589775 in Lapeer, Michigan

Provider Information

NPI Number: 1629589775
Entity Type: Individual
Name: Pamela Sue Southgate
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician
Enumeration Date: Oct 17, 2017
Last Updated: Oct 17, 2017

Practice Location

Address: 110 N SAGINAW ST
City: Lapeer
State: Michigan
ZIP Code: 48446-4600
Phone: (810) 535-5587

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician	374700000X	Primary

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