# THE BEHAVIORAL MEDICINE CLINIC OF NORTHWEST MICHIGAN, P.C.

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

## Provider details

- **NPI number:** 1154567279
- **Authorized official:** DR. TERRY M. DICKSON M.D. (PRESIDENT)
- **Authorized official phone:** (231) 932-1250

## Contact information

- **Practice address:** 745 S GARFIELD AVE, SUITE C, TRAVERSE CITY, MI 49686-3479
- **Practice address phone:** (231) 932-1250
- **Practice address fax:** (231) 932-1266
- **Mailing address:** 745 S GARFIELD AVE, SUITE C, TRAVERSE CITY, MI 49686-3479
- **Mailing address phone:** (231) 932-1250
- **Mailing address fax:** (231) 932-1266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 4301062201 | MI | Yes |

## Other

- **Enumeration date:** 12/18/2008
- **Last updated:** 08/27/2013