Organization
PROMEDICA CENTRAL CORPORATION OF MICHIGAN
Active
Parent organization
PROMEDICA PHYSICIAN GROUP INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROMEDICA PHYSICIAN GROUP INC
Authorized official
KRISTIN KNUEVEN (DELEGATED OFFICIAL)
(567) 585-1969
Entity
Organization
Contact information
Practice address
324 E MAUMEE ST, ADRIAN, MI 49221-2961
(517) 265-3307
Mailing address
1 SEAGATE STE 800, TOLEDO, OH 43604-1558
(567) 585-1969
(419) 824-7359
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Enumeration date
02/12/2019
Last updated
02/12/2019
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