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Organization
LAKE HURON URGENT CARE CENTER, LLC
Active
Organization
LAKE HURON URGENT CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER DOAN (CHIEF COMPLIANCE COUNSEL)
(909) 235-4307
Entity
Organization
Contact information
Practice address
4190 24TH AVE, FORT GRATIOT, MI 48059-3882
(810) 216-1366
(810) 216-1526
Mailing address
PO BOX 610669, PORT HURON, MI 48061-0669
(810) 216-1366
(810) 216-1526
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
NULL
207R00000X
Internal Medicine Physician
—
—
261QU0200X
Urgent Care Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/24/2016
Last updated
03/23/2017
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