Organization
LAKELAND NUCLEAR IMAGING, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DENNIS MACK (VICE PRESIDENT OF FACILITY & SUPPOR)
(269) 684-0259
Entity
Organization
Contact information
Practice address
122 GRANT ST, NILES, MI 49120-2281
(269) 684-0295
(269) 684-0189
Mailing address
6720 RED ARROW HWY, COLOMA, MI 49038-9703
(269) 684-0295
(269) 684-0189
Taxonomy
Speciality
Code
Description
License number
State
207UN0902X
Nuclear Imaging & Therapy Physician
Primary
—
MI
Other
Enumeration date
04/20/2006
Last updated
08/20/2007
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