Organization
CARE 1 OF BRONSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TYANN R BILLMAN PA-C (OWNER/PARTNER)
(517) 858-1400
Entity
Organization
Contact information
Practice address
735 E CHICAGO RD, BRONSON, MI 49028-1349
(517) 858-1400
(517) 858-1403
Mailing address
735 E CHICAGO RD, BRONSON, MI 49028-1349
(517) 858-1400
(517) 858-1403
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
5601003977
MI
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0A20032
BCBSM
MI
01
—
MI4324
MEDICARE PTAN
MI
Enumeration date
06/11/2010
Last updated
05/07/2015
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