| NPI | 1013930353 |
|---|---|
| Doing Business As | D/B/A CHERRY VALLEY MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | THOMAS L MICHALSEN President 815-229-2500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2008-08-13 |