| NPI | 1891043345 |
|---|---|
| Doing Business As | ASPIRUS ICE LAKE CLINIC |
| Entity Type | Organization |
| Authorized Contact | GLENN DOBSON CFO 906-265-0436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2012-08-15 |
| Last Update Date | 2015-09-16 |