| NPI | 1972534121 |
|---|---|
| Doing Business As | LAKES FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | THOMAS REYNOLDS Senior Director Of Network Admin 231-672-6470 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2009-01-06 |