ANTHONY W BOUTT MD PC
Radiology at Pine Grove Ave, Port Huron, MI

License number
Michigan 4301070173
Category
Radiology
Type
Surgery
Owner
Name: DR. ANTHONY W BOUTT M.D.
Title: PHYSICIAN/OWNER
Phone: (810) 987-3556
Address
Address
1522 Pine Grove Ave STE C, Port Huron, MI 48060
National Provider ID: 1073939732
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ANTHONY W. BOUTT, M.D., PC

Port Huron, MI

Industry:
Medical Doctor's Office
Doing business as:
Anthony W Boutt
Registration:
Nov 19, 2013
Addresses:
1522 Pne Grv Ave STE C, Port Huron, MI 48060 (Physical)
Michigan (Mailing)
State ID:
05476G
Business type:
Domestic Profit Corporation
Medical Doctor, Principal:
Anthony Boutt (Medical Doctor, Principal)
Agent:
Anthony W Boutt Md

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