# GREAT LAKES MEDICAL SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Great Lakes Urgent Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184705121
- **Authorized official:** MR. KYLE PRUETER (PRESIDENT)
- **Authorized official phone:** (419) 872-5343

## Contact information

- **Practice address:** 25660 DIXIE HWY, PERRYSBURG, OH 43551-2167
- **Practice address phone:** (419) 872-5343
- **Practice address fax:** (419) 872-2465
- **Mailing address:** 25660 DIXIE HWY, PERRYSBURG, OH 43551-2167
- **Mailing address phone:** (419) 872-5343
- **Mailing address fax:** (419) 872-2465

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QU0200X | Urgent Care Clinic/Center | 1515723 | OH | Yes |

## Other

- **Enumeration date:** 10/18/2006
- **Last updated:** 05/01/2009