Lake Country Urology Clinic, Pllc

NPI #1972677870 in Sturgis, Michigan

Provider Information

NPI Number: 1972677870
Entity Type: Organization
Organization Name: Lake Country Urology Clinic, Pllc
Primary Specialty: Urology
Enumeration Date: Nov 20, 2006
Last Updated: Oct 17, 2007

Practice Location

Address: 17 VINEWOOD AVE
City: Sturgis
State: Michigan
ZIP Code: 49091-2375
Phone: (269) 651-4708

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Urology	208800000X	Primary
Pediatrics	208000000X

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