Organization
CRESTON MEDICAL CENTER, PLLC
Active
Other names
Creston Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARGO MARYLAND APP PHD (ADMINISTRATOR)
(616) 776-0814
Entity
Organization
Contact information
Practice address
1330 PLAINFIELD AVE NE, GRAND RAPIDS, MI 49505-4913
(616) 776-1275
(616) 776-3713
Mailing address
PO BOX 2564, GRAND RAPIDS, MI 49501-2564
(616) 776-1275
(616) 776-3713
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
4301029675
MI
Other
Enumeration date
07/01/2008
Last updated
07/01/2008
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