| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 135 E M35, Gwinn, Michigan |
| Authorized Official Name and Position | Wendy Rautio (CONTROLLER) |
| Authorized Official Contact | 9063463202 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1110 10th Ave Menominee MI 49858-3058 Ph: () - | 135 E M35 Gwinn MI 49841-9160 Ph: (906) 346-3202 |
| NPI Number | 1295159788 |
|---|---|
| Provider Enumeration Date | 02/05/2014 |
| Last Update Date | 02/05/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295159788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Catherine A Kroll, Do,pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 135 E. M-35, Gwinn, MI 49841 Phone: 906-346-9275 | |