Organization
PARK ALLERGY CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL PARK MD (OWNER)
(269) 321-6673
Entity
Organization
Contact information
Practice address
430 W CENTRE AVE, PORTAGE, MI 49024-5304
(269) 321-6673
(269) 324-5594
Mailing address
430 W CENTRE AVE, PORTAGE, MI 49024-5304
(269) 321-6673
(269) 324-5594
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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