is a Primary Care in Port Huron, Michigan. practices all healthcare services and medical treatments related to Primary Care. The NPI Number for is 1972760692. The last update date is .
's current location address is 1217 Kearney St, Port Huron, Michigan. You can contact this provider via phone number 8109845001. The mailing address for is 1217 Kearney St, Port Huron, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1217 Kearney St, Port Huron, Michigan |
| Phone Number | 8109845001 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1972760692 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1217 Kearney St |
|---|---|
| City | Port Huron |
| State | Michigan (MI) |
| Post Code | 480603571 |
| Phone Number | 8109845001 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Primary Care |
|---|---|
| Taxonomy | 261Qp2300X |
| Licence No | 4301033555 |
|
Definition: Serves as the first point of contact for comprehensive healthcare services. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1360467 | MI | -- |
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