Organization
THREE RIVERS HEALTH SYSTEM, INC
Active
Parent organization
THREE RIVERS HEALTH SYSTEM, INC
Other names
Kalamazoo Foot & Ankle Specialists
Organization subpart
Yes
Provider details
NPI number
Legal business name
THREE RIVERS HEALTH SYSTEM, INC
Authorized official
JEFFERY COSTELLO (CFO)
(574) 647-3460
Entity
Organization
Contact information
Practice address
7971 MOORSBRIDGE RD, PORTAGE, MI 49024-4075
(269) 323-2094
(269) 323-2095
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992197925
—
MI
Enumeration date
02/27/2015
Last updated
07/22/2024
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