EASTES AND KHANUKOV MD PC
Osteopathic Medicine at 19 Mile Rd, Clinton Twp, MI

License number
Michigan 4301048104
Category
Osteopathic Medicine
Type
Internal Medicine
License number
Michigan 4301052968
Category
Osteopathic Medicine
Type
Internal Medicine
Owner
Name: DR. BRYAN K EASTES M.D.
Title: PRESIDENT
Phone: (586) 263-9999
Address
Address
15500 19 Mile Rd SUITE 360, Clinton Twp, MI 48038
National Provider ID: 1902092273
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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EASTES AND KHANUKOV, M.D., PC

Clinton Twp, MI

Status:
Inactive
Registration:
Feb 14, 1992
Addresses:
15500 19 Mile Rd STE 360, Clinton Township, MI 48038 (Physical)
Michigan (Mailing)
State ID:
454361
Business type:
Domestic Professional Service Corporation
Expiration:
7-15-2013
Agent:
Bryan Eastes Md

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