Organization · Type 2 NPI
Provemont Family Care, PLC
Primary Care Clinic/Center · Lake Leelanau, MI
NPI number
1013109214
Active
Practice location
49 N Eagle Hwy
Lake Leelanau, MI 49653-9778
Fax (231) 256-0671
Mailing address
PO Box 180
Lake Leelanau, MI 49653-0180
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Clinic/Center Primary | 261QP2300X | 5101016681 (MI) |
Primary Care Clinic/Center: Definition to come...
About NPI 1013109214
Provemont Family Care, PLC's National Provider Identifier is 1013109214, issued on Aug 13, 2007. The primary taxonomy on file is Primary Care Clinic/Center (261QP2300X), and the practice location is in Lake Leelanau, MI. The record was last updated on Aug 13, 2007.