Organization
PORTAGE PHYSICIAN PRACTICES INC
Active
Other names
UP MEDICAL GROUP - PORTAGE EXPRESS CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA BOWMAN (PRESIDENT)
(615) 920-7208
Entity
Organization
Contact information
Practice address
921 W SHARON AVE, HOUGHTON, MI 49931-1921
(906) 483-1777
(906) 483-4616
Mailing address
330 SEVEN SPRINGS WAY, BRENTWOOD, TN 37027-5098
(615) 920-7000
(615) 920-8775
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
06/23/2023
Last updated
06/23/2023
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