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1200 E Michigan Ave Lowr Level Lansing MI 48912-1800 | |
| (517) 364-5330 | |
| (517) 364-5335 |
| Full Name | |
|---|---|
| Speciality | Pain Medicine - Pain Medicine |
| Location | 1200 E Michigan Ave Lowr Level, Lansing, Michigan |
| Authorized Official Name and Position | Misty Gunter Russian (SUPERVISOR, PROVIDER ENROLLMENT) |
| Authorized Official Contact | 5172536308 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8175 Reliable Pkwy Chicago IL 60686-0081 Ph: (517) 364-5330 | 1200 E Michigan Ave Lowr Level Lansing MI 48912-1800 Ph: (517) 364-5330 |
| NPI Number | 1568046209 |
|---|---|
| Provider Enumeration Date | 05/10/2021 |
| Last Update Date | 03/26/2024 |
| Certification Date | 03/26/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568046209 | NPI | - | NPPES |
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