Organization
CRESTON MEDICAL CENTER, PLLC
Active
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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