NPI 1003559675

Panacea Portal LLC

Organisation Contractor Burton, MI

Practice location

Address: 6457 Hickory Ln, Burton, MI 48509-9303
Phone: (248) 509-4774

Authorised official

Name: Brian Rouse
Title: President
Phone: (248) 509-4774

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X

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Registry record

NPI: 1003559675
Entity type: Organization
NPI issued: 20 Apr 2022
Record last updated: 20 Apr 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.