| NPI | 1932294022 |
|---|---|
| Doing Business As | GREAT LAKES FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | PATRICIA BALLMAN Executive Director 814-452-5296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2010-11-02 |