Organization
LAKE COUNTRY UROLOGY CLINIC, PLLC
Active
Other names
LAKE COUNTRY HEALTH ALLIANCE
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANO L ORCA M.D. (PRESIDENT, PLLC)
(269) 651-4708
Entity
Organization
Contact information
Practice address
711 S HEALTH PKWY, THREE RIVERS, MI 49093-9387
(269) 651-4708
Mailing address
17 VINEWOOD AVE, STURGIS, MI 49091-2375
(269) 651-4708
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
—
Other
Enumeration date
03/09/2007
Last updated
10/17/2007
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