Organization
COLDWATER INTEGRATED MEDICINE
Active
Other names
Coldwater Private Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY SCOTT RUSSELL D.O. (PRINCIPAL OFFICER)
(517) 278-2519
Entity
Organization
Contact information
Practice address
892 E CHICAGO ST, SUITE A, COLDWATER, MI 49036-2063
(517) 278-2519
Mailing address
892 E CHICAGO ST, SUITE A, COLDWATER, MI 49036-2063
(517) 278-2519
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
5101011799
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5101011799
LICENSE
MI
Enumeration date
06/06/2014
Last updated
06/17/2014
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