Organization
CEDAR RUN FAMILY MEDICINE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS LASKEY MD (OWNER)
(231) 916-2024
Entity
Organization
Contact information
Practice address
520 S WILLIAMS ST, MANCELONA, MI 49659-9701
(231) 916-2024
(231) 916-2028
Mailing address
520 S WILLIAMS ST, MANCELONA, MI 49659-9701
(231) 916-2024
(231) 916-2028
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301085556
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4748889
—
MI
Enumeration date
11/17/2007
Last updated
11/17/2007
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