Boardman Health And Wellness, Pllc | |
4713 Pine St Sw S Boardman MI 49680-9761 | |
(231) 369-2656 | |
Not Available |
Full Name | Boardman Health And Wellness, Pllc |
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Speciality | Physician Assistant |
Location | 4713 Pine St Sw, S Boardman, Michigan |
Authorized Official Name and Position | Thomas Keane Stetler (OFFICER) |
Authorized Official Contact | 2313692656 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Boardman Health And Wellness, Pllc 4713 Pine St Sw S Boardman MI 49680-9761 Ph: (231) 369-2656 | Boardman Health And Wellness, Pllc 4713 Pine St Sw S Boardman MI 49680-9761 Ph: (231) 369-2656 |
NPI Number | 1063453363 |
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Provider Enumeration Date | 06/09/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1063453363 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 4301069428 (Michigan) | Primary |
363A00000X | Physician Assistant | 5601003799 (Michigan) | Primary |