Full Name | |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 2254 Main St, Ubly, Michigan |
Authorized Official Name and Position | Kenneth E Baranski (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 9899126225 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 273 2254 Main St Ubly MI 48475-0273 Ph: (989) 658-9191 | 2254 Main St Ubly MI 48475-0273 Ph: (989) 658-9191 |
NPI Number | 1427277847 |
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Provider Enumeration Date | 04/24/2007 |
Last Update Date | 06/17/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1427277847 | NPI | - | NPPES |
700C210080 | Other | MI | BLUE CROSS PIN NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (Michigan) | Primary |