Old Mission Wound Care Michigan PLLC
Specialist in Traverse City, MI. Organization (NPI-2).
NPI number1467282913
StatusActive
Last updated in NPPESAug 22, 2024
Details
- NPI
- 1467282913
- Entity type
- Organization (NPI-2)
- Legal business name
- Old Mission Wound Care Michigan PLLC
- Organization subpart
- No
- Enumeration date
- Aug 7, 2024
- Certification date
- Aug 22, 2024
- Last updated
- Aug 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | – | – | Yes |
Practice location
1989 Kroupa RdTraverse City, MI 49686-9759
Phone 231-260-4622
Mailing address
225 Matlage Way Unit 31Sugar Land, TX 77487-0807
Phone 231-260-4622
Authorized official
Christopher Paul Mason
Owner
2312604622
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