| NPI | 1770791147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGE YOUNG Adminstrator 231-924-4200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 207X00000X Orthopaedic Surgery | |
| 208000000X Pediatrics | |
| 208600000X Surgery | |
| 261QR1300X Clinic/Center, Rural Health | |
| 363AS0400X Physician Assistant, Surgical | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2010-05-14 |