| Grand Ledge Public Schools Health Center | |
|
820 Spring St Ste 100 Grand Ledge MI 48837-1834 | |
| (517) 253-6320 | |
| (517) 253-6321 |
| Full Name | Grand Ledge Public Schools Health Center |
|---|---|
| Speciality | Family Medicine - Adolescent Medicine |
| Location | 820 Spring St Ste 100, Grand Ledge, 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 |
|---|---|
| Grand Ledge Public Schools Health Center 8175 Reliable Pkwy Chicago IL 60686-0081 Ph: (517) 253-6320 | Grand Ledge Public Schools Health Center 820 Spring St Ste 100 Grand Ledge MI 48837-1834 Ph: (517) 253-6320 |
| NPI Number | 1841079787 |
|---|---|
| Provider Enumeration Date | 09/28/2023 |
| Last Update Date | 03/18/2024 |
| Certification Date | 03/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841079787 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 207QA0000X | Family Medicine - Adolescent Medicine | (* (Not Available)) | Primary |
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