| Donald G Prouty | |
|
820 N Pine River St Ithaca MI 48847-1118 | |
| (989) 330-1492 | |
| Not Available |
| Full Name | Donald G Prouty |
|---|---|
| Speciality | Family Medicine |
| Location | 820 N Pine River St, Ithaca, Michigan |
| Authorized Official Name and Position | Donald G Prouty (OWNER) |
| Authorized Official Contact | 9893301492 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Donald G Prouty 820 N Pine River St Ithaca MI 48847-1118 Ph: (989) 330-1492 | Donald G Prouty 820 N Pine River St Ithaca MI 48847-1118 Ph: (989) 330-1492 |
| NPI Number | 1164012019 |
|---|---|
| Provider Enumeration Date | 01/25/2021 |
| Last Update Date | 02/05/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164012019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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