Organization

John Street Clinic Pc

Internal Medicine Physician in Lake City, MI(View on Map)

Legal Business Name

John Street Clinic Pc

NPI Number

1033253133

NPI Type

Organization

Enumeration Date

02/20/2007

Specialties

(Taxonomies)

Code

207R00000X
208000000X

Primary Taxonomy

Yes
No

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 213
112 E JOHN ST

City

Cadillac
Lake City

State

MI
MI

Postal Code

49601-0213
49651

Country

US
US

Telephone Number

(231) 775-6076
(231) 839-4359

Authorized Official

Name

Sotero Ureta

Title or Position

OWNER

Telephone Number

(231) 839-4359

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/05/2010

Provider Address

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Organization

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Organization

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Organization

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