Individual
CATHERINE MARIE CHIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
820 N PINE RIVER ST, ITHACA, MI 48847-1118
(989) 875-3722
(989) 875-8903
Mailing address
PO BOX 994, ALMA, MI 48801-0994
(989) 466-7188
(989) 463-0663
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601001489
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0852915050
BCBSM
MI
Enumeration date
07/04/2006
Last updated
03/03/2011
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