Full Name | |
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Speciality | Clinic/Center |
Location | 2269 E Main St, Ubly, Michigan |
Authorized Official Name and Position | Kenneth Baranski (CFO) |
Authorized Official Contact | 9892691510 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1100 S Van Dyke Rd Bad Axe MI 48413-9615 Ph: (989) 269-9521 | 2269 E Main St Ubly MI 48475-9573 Ph: (989) 658-2159 |
NPI Number | 1467510206 |
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Provider Enumeration Date | 12/05/2006 |
Last Update Date | 11/14/2024 |
Medicare PECOS PAC ID | 6800709221 |
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Medicare Enrollment ID | O20040610000616 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467510206 | NPI | - | NPPES |