Full Name | |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 164 Mclean, Bruce Twp, Michigan |
Authorized Official Name and Position | Daria Jones (OPERATIONS PROJECT COORDINATOR) |
Authorized Official Contact | 8645010751 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
124 Allawood Ct Simpsonville SC 29681-6207 Ph: (864) 501-0751 | 164 Mclean Bruce Twp MI 48065-4919 Ph: (864) 501-0751 |
NPI Number | 1255106498 |
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Provider Enumeration Date | 11/17/2023 |
Last Update Date | 12/22/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255106498 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |