Great Lakes Medical Clinic, Pllc
NPI #1669614152 in Benton Harbor, Michigan
Provider Information
- NPI Number
- 1669614152
- Entity Type
- Organization
- Organization Name
- Great Lakes Medical Clinic, Pllc
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Mar 30, 2009
- Last Updated
- Mar 30, 2009
Practice Location
- Address
- 1850 PIPESTONE RD
- Address 2
- SUITE 102-B
- City
- Benton Harbor
- State
- Michigan
- ZIP Code
- 49022-2304
- Phone
- (269) 925-8386
Authorized Official
- Name
- MS. DAWN RENEE SCHRECKENGUST, PA-C
- Title
- PRESIDENT
- Phone
- (269) 925-8386
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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