Individual
MATTHEW SLACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
748 S MAIN ST, CHEBOYGAN, MI 49721-2220
(231) 487-2490
Mailing address
4100 EMBASSY DR SE, GRAND RAPIDS, MI 49546-2416
(616) 975-1845
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101027938
MI
Other
Enumeration date
04/05/2021
Last updated
08/06/2024
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