| |
2714 S 11th St, Suite A, Niles, MI 49120-4761 | |
(269) 683-1700 | |
(269) 683-7038 |
Full Name | |
---|---|
Type | Facility |
Speciality | Family Medicine |
Location | 2714 S 11th St, Niles, Michigan |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487952214 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | (* (Not Available)) | Secondary |
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
2714 S 11th St, Suite A, Niles, MI 49120-4761 Ph: (269) 683-1700 | 2714 S 11th St, Suite A, Niles, MI 49120-4761 Ph: (269) 683-1700 |