Organization
HACKLEY COMMUNITY CARE CENTER INC
Active
Organization
HACKLEY COMMUNITY CARE CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE H KOHN DO (MEDICAL DIRECTOR)
(231) 737-1335
Entity
Organization
Contact information
Practice address
2700 BAKER ST, 3RD FLOOR, MUSKEGON, MI 49444-2157
(231) 737-1335
(231) 737-0534
Mailing address
2700 BAKER ST, 3RD FLOOR, MUSKEGON, MI 49444-2157
(231) 737-1335
(231) 737-0534
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
10/07/2005
Last updated
11/24/2010
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