# LAKE HURON URGENT CARE CENTER, LLC

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

## Provider details

- **NPI number:** 1891246021
- **Authorized official:** CHRISTOPHER DOAN (CHIEF COMPLIANCE COUNSEL)
- **Authorized official phone:** (909) 235-4307

## Contact information

- **Practice address:** 4190 24TH AVE, FORT GRATIOT, MI 48059-3882
- **Practice address phone:** (810) 216-1366
- **Practice address fax:** (810) 216-1526
- **Mailing address:** PO BOX 610669, PORT HURON, MI 48061-0669
- **Mailing address phone:** (810) 216-1366
- **Mailing address fax:** (810) 216-1526

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 261QU0200X | Urgent Care Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/24/2016
- **Last updated:** 03/23/2017