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NPI Code Detail

MEDICARE: MONTROSE AFTER HOURS CLINIC PLLC

MEDICARE: MONTROSE AFTER HOURS CLINIC PLLC
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
1261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1952707523
Entity Type Code : Organization
Provider Name (Legal Business Name) : MONTROSE AFTER HOURS CLINIC PLLC
Provider Business Mailing Address
First Line : 190 E STATE ST
Second Line :
City : MONTROSE
State : MI
Zip : 48457-9144
Country : US
Telephone Number : 810-639-2056
Fax Number :
Provider Business Practice Location Address
First Line : 190 E STATE ST
Second Line :
City : MONTROSE
State : MI
Zip : 48457-9144
Country : US
Telephone Number : 810-639-2056
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. LARRY ALTON
Credential : DO
Telephone Number : 810-639-2056
Provider Enumeration Date : 11/10/2014
Last Update Date : 11/10/2014

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Directions to “MONTROSE AFTER HOURS CLINIC PLLC ” Practice Location

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