| Secret Forest Country Doctor | |
|
493 N Derenzy Rd Central Lake MI 49622-9566 | |
| (231) 544-7001 | |
| (231) 600-7054 |
| Full Name | Secret Forest Country Doctor |
|---|---|
| Speciality | Family Medicine |
| Location | 493 N Derenzy Rd, Central Lake, Michigan |
| Authorized Official Name and Position | Gloria Witt (PRESIDENT) |
| Authorized Official Contact | 2315447001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Secret Forest Country Doctor 493 N Derenzy Rd Central Lake MI 49622-9566 Ph: (231) 544-7001 | Secret Forest Country Doctor 493 N Derenzy Rd Central Lake MI 49622-9566 Ph: (231) 544-7001 |
| NPI Number | 1447967153 |
|---|---|
| Provider Enumeration Date | 11/02/2022 |
| Last Update Date | 11/02/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447967153 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
East Jordan Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7960 W. Old State Road, Central Lake, MI 49622 Phone: 231-544-3700 |