MEDICARE: IONIA ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	363AM0700X	Medical Physician Assistant
2	363LF0000X	Family Nurse Practitioner
3	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1134207624
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IONIA ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	330 LOVELL ST
Second Line	:
City	:	IONIA
State	:	MI
Zip	:	48846-9706
Country	:	US
Telephone Number	:	616-527-5732
Fax Number	:	616-527-5720

Provider Business Practice Location Address
First Line	:	330 LOVELL ST
Second Line	:
City	:	IONIA
State	:	MI
Zip	:	48846-9706
Country	:	US
Telephone Number	:	616-527-5732
Fax Number	:	616-527-5720

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	CHERYL HILDEBRANDT
Credential	:
Telephone Number	:	616-527-5732

Provider Enumeration Date	:	11/01/2006
Last Update Date	:	09/12/2017

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Directions to “IONIA ASSOCIATES LLC ” Practice Location

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