| Crystal Lake Clinic, P.c. | |
|
2283 E M 113 Kingsley MI 49649-9370 | |
| (231) 882-9661 | |
| (231) 882-9616 |
| Full Name | Crystal Lake Clinic, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 2283 E M 113, Kingsley, Michigan |
| Authorized Official Name and Position | Richard C Nielsen (PRESIDENT) |
| Authorized Official Contact | 2318829661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crystal Lake Clinic, P.c. 6227 Frankfort Hwy Benzonia MI 49616-8632 Ph: (231) 882-9661 | Crystal Lake Clinic, P.c. 2283 E M 113 Kingsley MI 49649-9370 Ph: (231) 882-9661 |
| NPI Number | 1316177611 |
|---|---|
| Provider Enumeration Date | 07/21/2009 |
| Last Update Date | 11/06/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316177611 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Grand Traverse County Health Department Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 S Brownson Ave, Kingsley, MI 49649 Phone: 231-263-5895 |