Organization
SPECTRUM HEALTH KELSEY
Active
Other names
Lakeview Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN K JOHNSON (VP FINANCE)
(616) 225-6428
Entity
Organization
Contact information
Practice address
418 WASHINGTON ST, LAKEVIEW, MI 48850-7102
(989) 352-6435
(989) 352-8451
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
(616) 486-6702
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
07/09/2010
Last updated
07/19/2016
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