Organization
PORTAGE PHYSICIAN PRACTICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONICA BOWMAN (PRESIDENT)
(615) 920-7000
Entity
Organization
Contact information
Practice address
600 MACINNES DR, HOUGHTON, MI 49931-1144
(906) 483-1860
(906) 483-1815
Mailing address
103 POWELL CT, BRENTWOOD, TN 37027-5079
(615) 372-8500
(615) 372-8572
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
10/04/2013
Last updated
02/07/2023
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