Lakeshore Clinic, PLLC
Clinic/Center, Primary Care in Muskegon Heights, MI. Organization (NPI-2).
NPI number1003036732
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1003036732
- Entity type
- Organization (NPI-2)
- Legal business name
- Lakeshore Clinic, PLLC
- Organization subpart
- No
- Enumeration date
- Apr 26, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | 5101006386 | MI | Yes |
Practice location
445 E Sherman BlvdMuskegon Heights, MI 49444-2203
Phone 231-739-4359 · Fax 231-733-6151
Mailing address
445 E Sherman BlvdMuskegon Heights, MI 49444-2203
Phone 231-739-4359 · Fax 231-733-6151
Authorized official
Darien Lamarck Smith
Director
2317394359
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