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Organization
THORNAPPLE VALLEY FAMILY PHYSICIANS PC
Active
Organization
THORNAPPLE VALLEY FAMILY PHYSICIANS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE B EBAUGH M.D. (PRESIDENT)
(269) 948-8057
Entity
Organization
Contact information
Practice address
1005 W GREEN ST, HASTINGS, MI 49058-1712
(269) 948-8057
(269) 948-8964
Mailing address
1005 W GREEN ST, HASTINGS, MI 49058-1712
(269) 948-8057
(269) 948-8964
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301046093
MI
Other
Enumeration date
07/19/2007
Last updated
04/27/2009
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