| NPI | 1295148336 |
|---|---|
| Former Legal Business Name | COLDWATER PRIVATE MEDICINE |
| Entity Type | Organization |
| Authorized Contact | JEFFREY SCOTT RUSSELL Principal Officer 517-278-2519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 5101011799) |
| Enumeration Date | 2014-06-06 |
| Last Update Date | 2014-06-17 |