MEDICARE: WILLOW ENTERPRISES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QX0100X	Occupational Medicine Clinic/Center	4301049406	MI

General Provider Information

NPI Number	:	1053434209
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLOW ENTERPRISES

Provider Business Mailing Address
First Line	:	1644 STONE ST
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-3344
Country	:	US
Telephone Number	:	810-982-8016
Fax Number	:	810-982-3590

Provider Business Practice Location Address
First Line	:	1644 STONE ST
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060-3344
Country	:	US
Telephone Number	:	810-982-8016
Fax Number	:	810-982-3590

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. GALE S. NORTHCROSS
Credential	:	MD
Telephone Number	:	810-982-8016

Provider Enumeration Date	:	04/10/2007
Last Update Date	:	08/22/2020

Similar Medicare Providers

1598779308 — WRIGHT & FILIPPIS, LLC
Practice Location Address:

1604 STONE ST
PORT HURON, MI
48060-3344

Practice Phone: 810-385-6330
Practice Fax: 810-385-6640

1376558122 — PORT HURON OPHTHALMOLOGY, PLLC
Practice Location Address:

1660 STONE ST
PORT HURON, MI
48060-3344

Practice Phone: 810-985-9600
Practice Fax: 810-985-9244

1922153022 — WRIGHT & FILIPPIS, LLC
Practice Location Address:

1604 STONE ST
PORT HURON, MI
48060-3344

Practice Phone: 810-385-6330
Practice Fax: 810-385-6640

1174787006 — CURTIS JEVENS P.T.
Practice Location Address:

1652 STONE ST
PORT HURON, MI
48060-3344

Practice Phone: 810-982-6200
Practice Fax:

1922857218 — OTTO BOCK PATIENT CARE, LLC
Practice Location Address:

1604 STONE ST
PORT HURON, MI
48060-3344

Practice Phone: 810-385-6330
Practice Fax:

1639917388 — MARIA LAURA HERNANDEZ GONZALEZ
Practice Location Address:

6224 NW KOA CT
PORT SAINT LUCIE, FL
34983-3344

Practice Phone: 772-812-1832
Practice Fax:

Directions to “WILLOW ENTERPRISES ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.