Organization
HPCN
Active
Other names
HACKLEY SPECIALITY CARE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LINDA ELLISON (MANAGER)
(231) 728-1678
Entity
Organization
Contact information
Practice address
1675 LEAHY ST, SUITE 324B, MUSKEGON, MI 49442-5500
(231) 726-5075
(231) 728-7827
Mailing address
1675 LEAHY ST, SUITE 324B, MUSKEGON, MI 49442-5500
(231) 726-5075
(231) 728-7827
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4744440
—
MI
Enumeration date
09/12/2006
Last updated
04/20/2008
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