Healthcare Provider Details
I. General information
NPI: 1306238241
Provider Name (Legal Business Name): LANSING MEDICAL P.L.L.C
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/02/2015
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
930 E MOUNT HOPE AVE
LANSING MI
48910-3280
US
IV. Provider business mailing address
930 E MOUNT HOPE AVE
LANSING MI
48910-3280
US
V. Phone/Fax
- Phone: 517-253-7764
- Fax: 517-253-7783
- Phone: 517-253-7764
- Fax: 517-253-7783
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
REMONA
LYSA
BROWN
Title or Position: MANAGER
Credential:
Phone: 517-253-7764