Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 2301005069 | MI |
N | 111NN0400X | Neurology | 2301005069 | MI |
N | 111NN1001X | Nutrition | 2301005069 | MI |
N | 111NR0200X | Radiology | 2301005069 | MI |
N | 213ER0200X | Radiology | 2301005069 | MI |
N | 111NS0005X | Chiropractic Sports Physician | 2301005069 | MI |
N | 111NT0100X | Thermography | 2301005069 | MI |
NPI | 1649215716 |
---|---|
Provider Name | Dr. Randall Thomas Louzon |
First Address | Grosse Ile, MI 48138-1500 |
Second Address | Taylor, MI 48180-1836 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 08/07/2007 |