Individual
DR. GUSTAV JALIANG LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
116 W MITCHELL ST, PETOSKEY, MI 49770-2324
(231) 348-2828
(231) 348-9609
Mailing address
116 W MITCHELL ST, PETOSKEY, MI 49770-2324
(231) 348-2828
(231) 348-9609
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
4301053321
MI
Other
Enumeration date
01/04/2007
Last updated
06/10/2011
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