# VISION OF HEALTH AND FUNCTIONAL MEDICINE PC

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

## Provider details

- **NPI number:** 1366761520
- **Authorized official:** VERNON EUGENE PROCTOR MD (OWNER)
- **Authorized official phone:** (231) 745-4914

## Contact information

- **Practice address:** 1234 WASHINGTON ST, BALDWIN, MI 49304-7737
- **Practice address phone:** (231) 745-4914
- **Practice address fax:** (269) 745-4922
- **Mailing address:** 1234 WASHINGTON ST, BALDWIN, MI 49304-7737
- **Mailing address phone:** (231) 745-4914
- **Mailing address fax:** (269) 745-4922

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0500X | Preventive Medicine/Occupational Environmental Medicine Physician | 4301089365 | MI | — |
| 208D00000X | General Practice Physician | 4301089365 | MI | Yes |

## Other

- **Enumeration date:** 05/26/2010
- **Last updated:** 05/26/2010