Organization
NORTHERN MICHIGAN PHYSICAL MEDICINE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GERALD KLOOSTER II D.O. (OFFICER)
(231) 347-9800
Entity
Organization
Contact information
Practice address
2780 CHARLEVOIX AVE, 19, PETOSKEY, MI 49770-8058
(231) 347-9800
(231) 347-9850
Mailing address
2780 CHARLEVOIX AVE, 19, PETOSKEY, MI 49770-8058
(231) 347-9800
(231) 347-9850
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
GK012925
MI
Other
Enumeration date
11/02/2007
Last updated
11/13/2007
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