# BOARDMAN HEALTH AND WELLNESS, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063453363
- **Authorized official:** THOMAS KEANE STETLER PA-C (OFFICER)
- **Authorized official phone:** (231) 369-2656

## Contact information

- **Practice address:** 4713 PINE ST SW, S BOARDMAN, MI 49680-9761
- **Practice address phone:** (231) 369-2656
- **Mailing address:** 4713 PINE ST SW, S BOARDMAN, MI 49680-9761
- **Mailing address phone:** (231) 369-2656

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 4301069428 | MI | — |
| 363A00000X | Physician Assistant | 5601003799 | MI | Yes |

## Other

- **Enumeration date:** 06/09/2006
- **Last updated:** 09/11/2025