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Organization

AMBULATORY CARE CLINIC OF IONIA PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERESA SMITH (OFFICE MANAGER)
(616) 522-9110
Entity
Organization

Contact information

Practice address
3015 S STATE RD, IONIA, MI 48846-9416
(616) 522-9110
(616) 522-9114
Mailing address
3015 S STATE RD, IONIA, MI 48846-9416
(616) 522-9110
(616) 522-9114

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
4301063290
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4118690
MI
Enumeration date
07/01/2008
Last updated
07/01/2008
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