Crystal Lake Clinic P.c. | |
1975 Stirling Dr Interlochen MI 49643-9264 | |
(231) 275-7965 | |
Not Available |
Full Name | Crystal Lake Clinic P.c. |
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Speciality | Family Medicine |
Location | 1975 Stirling Dr, Interlochen, Michigan |
Authorized Official Name and Position | Richard C Nielsen (PRESIDENT) |
Authorized Official Contact | 2318829661 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Crystal Lake Clinic P.c. 6227 Frankfort Hwy Benzonia MI 49616-9654 Ph: (231) 882-9661 | Crystal Lake Clinic P.c. 1975 Stirling Dr Interlochen MI 49643-9264 Ph: (231) 275-7965 |
NPI Number | 1417902057 |
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Provider Enumeration Date | 05/23/2006 |
Last Update Date | 02/14/2011 |
Identifier | Type | State | Issuer |
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1417902057 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
208000000X | Pediatrics | (* (Not Available)) | Secondary |