Organization
LIFETIME FAMILY CARE, P.L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IA YANG KUE D.O. (PHYSICIAN)
(586) 293-1340
Entity
Organization
Contact information
Practice address
31022 UTICA RD, FRASER, MI 48026-2534
(586) 293-1340
(586) 293-7079
Mailing address
31022 UTICA RD, FRASER, MI 48026-2534
(586) 293-1340
(586) 293-7079
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101015717
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4977139
—
MI
Enumeration date
06/20/2006
Last updated
09/04/2007
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