Organization
LAKELAND FAMILY CARE OF NILES
Active
Parent organization
FOUR FLAGS HEALTH VENTURE
Organization subpart
Yes
Provider details
NPI number
Legal business name
FOUR FLAGS HEALTH VENTURE
Authorized official
ROBIN MACK (V.P OPERATIONS PHYSICIAN SERVICES)
(269) 983-8574
Entity
Organization
Contact information
Practice address
4 LONGMEADOW VILLAGE DR, SUITE 2, NILES, MI 49120-7809
(269) 684-6000
(269) 684-1388
Mailing address
4 LONGMEADOW VILLAGE DR, SUITE 2, NILES, MI 49120-7809
(269) 684-6000
(269) 684-1388
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/27/2008
Last updated
10/16/2008
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