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Organization

BRONSON PRACTICE MANAGEMENT

Active
Parent organization
BRONSON PRACTICE MANAGEMENT
Other names
Bronson FastCare
Organization subpart
Yes

Provider details

NPI number
Legal business name
BRONSON PRACTICE MANAGEMENT
Authorized official
JAMES B FALAHEE JR. (SVP LEGAL AFFAIRS, C)
(269) 341-6000
Entity
Organization

Contact information

Practice address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-7654
(269) 341-8743
Mailing address
601 JOHN ST, BOX 42, KALAMAZOO, MI 49007-5341
(269) 341-8419

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080C910950
BCBSM
MI
Enumeration date
11/17/2006
Last updated
07/24/2014
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