| NPI | 1366527814 |
|---|---|
| Doing Business As | HACKLEYLAKES OBGYN |
| Entity Type | Organization |
| Authorized Contact | LAVONNE JONES Office Manager 231-727-7910 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VX0000X Obstetrics & Gynecology, Obstetrics |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2008-09-16 |