| Northern Phototherapy Management Facility Llc | |
| 
					337 E Houghton Ave Suite 3 West Branch MI 48661-1127  | |
| (989) 343-1000 | |
| (989) 345-5734 | 
| Full Name | Northern Phototherapy Management Facility Llc | 
|---|---|
| Speciality | Internal Medicine | 
| Location | 337 E Houghton Ave, West Branch, Michigan | 
| Authorized Official Name and Position | Joseph J Martines (OWNER) | 
| Authorized Official Contact | 9893431000 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Northern Phototherapy Management Facility Llc 337 E Houghton Ave Suite 3 West Branch MI 48661-1127 Ph: (989) 343-1000  | Northern Phototherapy Management Facility Llc 337 E Houghton Ave Suite 3 West Branch MI 48661-1127 Ph: (989) 343-1000  | 
| NPI Number | 1831251982 | 
|---|---|
| Provider Enumeration Date | 12/15/2006 | 
| Last Update Date | 08/22/2020 | 
| Medicare PECOS PAC ID | 4880644251 | 
|---|---|
| Medicare Enrollment ID | O20050125000186 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1831251982 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary | 
| Provider Name | Lori A Tetu | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1639710890 PECOS PAC ID: 3779910328 Enrollment ID: I20200221000064  | 
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Trust Care Clinic Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Court St Lowr Level, Suite B, West Branch, MI 48661 Phone: 989-345-2068  | |
Mclaren Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2331 Progress St, Suite D, West Branch, MI 48661 Phone: 989-345-1184 Fax: 989-345-6944  | |
Mclaren Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Court St, West Branch, MI 48661 Phone: 989-345-7000 Fax: 989-345-7479  | |
Mclaren Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2110 S M 76 Ste 6, West Branch, MI 48661 Phone: 989-345-1184 Fax: 989-345-6944  | |
Mclaren Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 559 Progress St, Suite A, Bldg A, West Branch, MI 48661 Phone: 989-345-0945 Fax: 989-345-2831  |