| NPI | 1417481136 |
|---|---|
| Doing Business As | NORTHERN LAKES INTEGRATED HEALTH CLINIC |
| Entity Type | Organization |
| Authorized Contact | NANCY STEVENSON COO 231-922-4850 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2023-11-28 |