Healthcare Provider Details

I. General information

NPI: 1144983495
Provider Name (Legal Business Name): MRC INDUSTRIES INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2021
Last Update Date: 10/14/2021
Certification Date: 10/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2538 SOUTH 26TH STREET
KALAMAZOO MI
49048
US

IV. Provider business mailing address

2538 SOUTH 26TH STREET
KALAMAZOO MI
49048
US

V. Phone/Fax

Practice location:
  • Phone: 269-343-0747
  • Fax: 269-343-2007
Mailing address:
  • Phone: 269-343-0747
  • Fax: 269-343-2007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CHRIS ZEIGLER
Title or Position: PRESIDENT
Credential:
Phone: 269-303-6074