| NPI | 1912195876 |
|---|---|
| Other Name | NORTHSIDE IMMEDIATE CARE URGENT CARE |
| Entity Type | Organization |
| Authorized Contact | ERWIN L GRASMAN Owner/President 231-744-4743 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2007-10-04 |