Most Relevant Information
Provider Data
| NPI Number: | 1003478256 |
| Provider Name: | PHOENIX GREENWOOD-HALLER |
| Entity Type: | Individual |
| Taxonomy Code: | 247200000X |
| Specialty: | Technician, Other |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/08/2019 |
| Last Updated: | 07/08/2019 |
Provider Practice Location
1114 E CHIPPEWA ST
MOUNT PLEASANT
MI
488581853
Practice Location Phone/Fax
| Phone: | 9898548334 |
| Fax: |
Provider Mailing Location
1403 HAYES ST
SAGINAW
MI
486024568
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |