Crystal Lake Clinic P.c.
NPI #1053780072 in Elk Rapids, Michigan
Provider Information
- NPI Number
- 1053780072
- Entity Type
- Organization
- Organization Name
- Crystal Lake Clinic P.c.
- Primary Specialty
- Family Medicine
- Enumeration Date
- Sep 21, 2015
- Last Updated
- Sep 21, 2015
Practice Location
- Address
- 124 AMES ST
- City
- Elk Rapids
- State
- Michigan
- ZIP Code
- 49629-9449
- Phone
- (231) 264-8282
Authorized Official
- Name
- RICHARD C NIELSEN, M.D.
- Title
- PRESIDENT
- Phone
- (231) 882-9661
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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