| NPI | 1366425852 |
|---|---|
| Doing Business As | UPPER GREAT LAKES VASCULAR, P.C |
| Entity Type | Organization |
| Authorized Contact | JOEL A JOHNSON President 906-225-7701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MI 4301057398) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2020-08-22 |