Lake Country Urology Clinic, Pllc

NPI #1528190303 in Dowagiac, Michigan

Provider Information

NPI Number: 1528190303
Entity Type: Organization
Organization Name: Lake Country Urology Clinic, Pllc
Primary Specialty: Urology
Enumeration Date: Mar 9, 2007
Last Updated: Oct 17, 2007

Practice Location

Address: 420 W HIGH ST
City: Dowagiac
State: Michigan
ZIP Code: 49047-1943
Phone: (269) 651-4708

Authorized Official

Name: MARIANO L ORCA, M.D.
Title: PRESIDENT, PLLC
Phone: (269) 651-4708

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary

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