| Clear The Dermatology Clinic Pc | |
|
116 W Mitchell St Petoskey MI 49770-2357 | |
| (231) 348-0766 | |
| Not Available |
| Full Name | Clear The Dermatology Clinic Pc |
|---|---|
| Speciality | Physician Assistant - Medical |
| Location | 116 W Mitchell St, Petoskey, Michigan |
| Authorized Official Name and Position | Christy Racignol (BILLING COORDINATOR) |
| Authorized Official Contact | 2313482828 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear The Dermatology Clinic Pc 116 W Mitchell St Petoskey MI 49770-2357 Ph: (231) 348-0766 | Clear The Dermatology Clinic Pc 116 W Mitchell St Petoskey MI 49770-2357 Ph: (231) 348-0766 |
| NPI Number | 1164874616 |
|---|---|
| Provider Enumeration Date | 07/08/2016 |
| Last Update Date | 08/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164874616 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 4301053221 (Michigan) | Secondary |
| 363AM0700X | Physician Assistant - Medical | 5601004147 (Michigan) | Primary |
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