Organization
MUNSON MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN O SMITH (PRESIDENT AMBULATORY CLINICS)
(231) 935-5199
Entity
Organization
Contact information
Practice address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 935-9227
(231) 935-8215
Mailing address
2513 MOMENTUM PL, CHICAGO, IL 60689-5325
(231) 935-6080
(231) 935-6081
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
Primary
—
—
Other
Enumeration date
01/22/2019
Last updated
09/22/2022
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