ProviderBusinessMailingAddressFaxNumber = '5175744201'
NPI
LastName
FirstName
MidName
Organization
Mailing Address
City
State
Zip
1750735197
MI HEALING SPACE
601 ABBOT RD
EAST LANSING
MI
488233366
1851712798
JOHN ROBERT SHAW
601 ABBOT RD STE 103
EAST LANSING
MI
488233366
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