# VILLAGE FAMILY PRACTICE PLC

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

## Provider details

- **NPI number:** 1972797652
- **Authorized official:** DR. PEGGY ANDERSON D.O. (OWNER)
- **Authorized official phone:** (231) 935-0708

## Contact information

- **Practice address:** 810 COTTAGEVIEW DR, TRAVERSE CITY, MI 49684
- **Practice address phone:** (231) 935-0708
- **Practice address fax:** (231) 935-0712
- **Mailing address:** 810 COTTAGEVIEW DR, TRAVERSE CITY, MI 49684
- **Mailing address phone:** (231) 935-0708
- **Mailing address fax:** (231) 935-0712

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 5101009433 | MI | Yes |

## Other

- **Enumeration date:** 09/05/2007
- **Last updated:** 12/10/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4602721 | — | MI |