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106 S School Rd Daggett MI 49821-8555 | |
(906) 753-2155 | |
(906) 753-2716 |
Full Name | |
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Speciality | Clinic/Center |
Location | 106 S School Rd, Daggett, Michigan |
Authorized Official Name and Position | Denise K Stroobants (CREDENTIALING SPECIALIST) |
Authorized Official Contact | 9204457226 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 1866 Green Bay WI 54305-1866 Ph: (920) 445-7222 | 106 S School Rd Daggett MI 49821-8555 Ph: (906) 753-2155 |
NPI Number | 1043668643 |
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Provider Enumeration Date | 05/25/2016 |
Last Update Date | 04/06/2022 |
Medicare PECOS PAC ID | 2163461781 |
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Medicare Enrollment ID | O20170227000805 |
Identifier | Type | State | Issuer |
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1043668643 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |