Basic Information
| Provider Information | |||||||||
| NPI: | 1992268072 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RADEMACHER | ||||||||
| FirstName: | COURTNEY | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1870 S FINN RD | ||||||||
| Address2: | |||||||||
| City: | MUNGER | ||||||||
| State: | MI | ||||||||
| PostalCode: | 487479707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9892254579 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1500 WEISS ST | ||||||||
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| City: | SAGINAW | ||||||||
| State: | MI | ||||||||
| PostalCode: | 486025251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9894972500 | ||||||||
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| ProviderEnumerationDate: | 04/07/2019 | ||||||||
| LastUpdateDate: | 04/07/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 246RP1900X | MI | Y | Technologists, Technicians & Other Technical Service Providers | Technician, Pathology | Phlebotomy |
No ID Information.