Individual
ELLEN E VAN LAANEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
440 WOODWARD AVE, IRON MOUNTAIN, MI 49801-4631
(906) 776-9040
(906) 774-7279
Mailing address
440 WOODWARD AVE, IRON MOUNTAIN, MI 49801-4631
(906) 776-9040
(906) 774-7279
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101008354
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112121767
—
MI
05
—
30100100
—
WI
Enumeration date
08/14/2006
Last updated
03/31/2014
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