| Grand Traverse County Health Department | |
| 
					112 S Brownson Ave Kingsley MI 49649  | |
| (231) 263-5895 | |
| Not Available | 
| Full Name | Grand Traverse County Health Department | 
|---|---|
| Speciality | Clinic/center | 
| Location | 112 S Brownson Ave, Kingsley, Michigan | 
| Authorized Official Name and Position | Erin Carlson (ACCOUNTING TECHNICIAN) | 
| Authorized Official Contact | 2319956103 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Grand Traverse County Health Department 2600 Lafranier Rd Ste A Traverse City MI 49686-4765 Ph: (231) 995-6111  | Grand Traverse County Health Department 112 S Brownson Ave Kingsley MI 49649 Ph: (231) 263-5895  | 
| NPI Number | 1528382538 | 
|---|---|
| Provider Enumeration Date | 03/19/2010 | 
| Last Update Date | 09/12/2016 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1528382538 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary | 
Crystal Lake Clinic, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2283 E M 113, Kingsley, MI 49649 Phone: 231-882-9661 Fax: 231-882-9616  |