Organization
PROVEMONT FAMILY CARE, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONA D. ALBA DO (PRESIDENT)
(231) 256-0606
Entity
Organization
Contact information
Practice address
49 N EAGLE HWY, LAKE LEELANAU, MI 49653-9778
(231) 256-0606
(231) 256-0671
Mailing address
PO BOX 180, LAKE LEELANAU, MI 49653-0180
(231) 256-0606
(231) 256-0671
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
5101016681
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1164458295
NPI
—
05
—
4849101
—
MI
Enumeration date
08/13/2007
Last updated
08/13/2007
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