Healthcare Provider Details

I. General information

NPI: 1568688992
Provider Name (Legal Business Name): LANSING URGENT CARE PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 08/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 N CLIPPERT ST
LANSING MI
48912-4780
US

IV. Provider business mailing address

505 N CLIPPERT ST
LANSING MI
48912-4780
US

V. Phone/Fax

Practice location:
  • Phone: 517-333-9200
  • Fax:
Mailing address:
  • Phone: 517-333-9200
  • Fax: 517-333-9201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number5101014149
License Number StateMI

VIII. Authorized Official

Name: DR. TERRY MATTHEWS
Title or Position: OWNER MEMBER PLC
Credential: D.O.
Phone: 517-333-9200