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Organization

PRIMARY HEALTH SERVICES PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRADLEY L BLISS PA (PHYSICIAN ASSISTANT)
(231) 843-8452
Entity
Organization

Contact information

Practice address
505 W LUDINGTON AVE, LUDINGTON, MI 49431-2029
(231) 843-8452
Mailing address
505 W LUDINGTON AVE, LUDINGTON, MI 49431-2029
(231) 843-8452

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010E310070
BCBS GROUP NUMBER
MI
05
104694643
MI
Enumeration date
08/16/2006
Last updated
09/06/2017
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