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427 S Stephenson Ave Suite 215 Iron Mountain MI 49801-3458 | |
| (906) 774-3323 | |
| (906) 774-2556 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 427 S Stephenson Ave, Iron Mountain, Michigan |
| Authorized Official Name and Position | Laurence Ziomkowski (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9062279116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
427 S Stephenson Ave Suite 215 Iron Mountain MI 49801-3458 Ph: (906) 774-3323 | 427 S Stephenson Ave Suite 215 Iron Mountain MI 49801-3458 Ph: (906) 774-3323 |
| NPI Number | 1790934263 |
|---|---|
| Provider Enumeration Date | 09/09/2008 |
| Last Update Date | 03/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790934263 | NPI | - | NPPES |
| 7509105360 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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