Organization
SUNDARA NPHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINE SUSAN MARTIN (OPERATIONS MANAGER)
(906) 225-0848
Entity
Organization
Contact information
Practice address
410 LINCOLN AVE, MARQUETTE, MI 49855
(906) 225-0848
(906) 228-2050
Mailing address
410 LINCOLN AVE, MARQUETTE, MI 49855
(906) 225-0848
(906) 228-2050
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
AL520007247
MI
Other
Enumeration date
02/25/2010
Last updated
02/25/2010
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