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Organization
TIMOTHY C ST. JOHN II
Active
Organization
TIMOTHY C ST. JOHN II
Active
Other names
Houghton Lake Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY ST JOHN DPM (PRESIDENT)
(989) 366-8332
Entity
Organization
Contact information
Practice address
3179 W HOUGHTON LAKE DR, HOUGHTON LAKE, MI 48629-9256
(989) 366-8332
Mailing address
4310 LEONARD ST NW, SUITE 103, WALKER, MI 49534-8447
(616) 453-6329
(616) 453-1725
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3119585
—
MI
Enumeration date
12/24/2005
Last updated
01/04/2010
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