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Organization

LAKELAND MEDICAL PRACTICES

Active
Other names
Lakeland Ear Nose & Thoart
Organization subpart
No

Provider details

NPI number
Authorized official
JANICE CROCKER (DIRECTOR, PRACTICE OPERATIONS)
(269) 687-1152
Entity
Organization

Contact information

Practice address
9045 US HIGHWAY 31, STE 3, BERRIEN SPRINGS, MI 49103-1804
(269) 471-9702
(269) 471-9707
Mailing address
PO BOX 458, NILES, MI 49120-0458
(269) 471-9702
(269) 471-9707

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
4301074795
MI

Other

Enumeration date
05/25/2011
Last updated
05/25/2011
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