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112 John Street Lake City MI 49601 | |
| (231) 839-4359 | |
| (231) 839-0223 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 112 John Street, Lake City, Michigan |
| Authorized Official Name and Position | Sotero Ureta (PRESIDENT) |
| Authorized Official Contact | 2318394359 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 213 Cadillac MI 49601-0213 Ph: (231) 775-6076 | 112 John Street Lake City MI 49601 Ph: (231) 839-4359 |
| NPI Number | 1689716557 |
|---|---|
| Provider Enumeration Date | 02/13/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689716557 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
John Street Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 E John St, Lake City, MI 49651 Phone: 231-839-4359 Fax: 231-839-0223 | |
Maple Ridge Living Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2575 W Houghton Lake Rd, Lake City, MI 49651 Phone: 231-839-1011 | |