Organization
FOUR FLAGS UROLOGY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY GEEGAN MIDDLETON (EXECUTIVE DIRECTOR)
(269) 684-0259
Entity
Organization
Contact information
Practice address
60 N SAINT JOSEPH AVE, SUITE E, NILES, MI 49120-2296
(269) 684-6696
(269) 684-5286
Mailing address
60 N SAINT JOSEPH AVE, SUITE E, NILES, MI 49120-2296
(269) 684-6696
(269) 684-5286
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301103271
MI
Other
Enumeration date
02/06/2006
Last updated
08/22/2020
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