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NPI Code Detail

MEDICARE: RADIANT HEALTHCARE, PC

MEDICARE: RADIANT HEALTHCARE, PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208100000XPhysical Medicine & Rehabilitation Physician

General Provider Information

NPI Number : 1336504844
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIANT HEALTHCARE, PC
Provider Business Mailing Address
First Line : 1346 COLUMBIA AVE W
Second Line : SUITE 101
City : BATTLE CREEK
State : MI
Zip : 49015-3067
Country : US
Telephone Number : 269-964-3300
Fax Number : 269-964-3366
Provider Business Practice Location Address
First Line : 1346 COLUMBIA AVE W
Second Line : SUITE 101
City : BATTLE CREEK
State : MI
Zip : 49015-3067
Country : US
Telephone Number : 269-964-3300
Fax Number : 269-964-3366
Authorized Official
Title or Position : CLINIC DIRECTOR
Name : DR. MARK E MCCULLOUGH
Credential : DC
Telephone Number : 269-964-3300
Provider Enumeration Date : 12/28/2015
Last Update Date : 12/29/2015

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Directions to “RADIANT HEALTHCARE, PC ” Practice Location

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