Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 5991 95th Ave, Evart, Michigan |
Authorized Official Name and Position | Thomas Knoerl (CFO) |
Authorized Official Contact | 2318327177 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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100 Michigan St Ne Mc845 Grand Rapids MI 49503-2560 Ph: () - | 5991 95th Ave Evart MI 49631-9386 Ph: (231) 832-8700 |
NPI Number | 1538265343 |
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Provider Enumeration Date | 09/16/2006 |
Last Update Date | 06/03/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1538265343 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 670021 (Michigan) | Primary |