Healthcare Provider Details

I. General information

NPI: 1841578564
Provider Name (Legal Business Name): QUICK CARE FAMILY MEDICAL CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2011
Last Update Date: 04/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 S US HIGHWAY 131 SUITE 4
PETOSKEY MI
49770-8344
US

IV. Provider business mailing address

1890 S US HIGHWAY 131 SUITE 4
PETOSKEY MI
49770-8344
US

V. Phone/Fax

Practice location:
  • Phone: 231-487-2000
  • Fax:
Mailing address:
  • Phone: 231-487-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. GUSTAV LO
Title or Position: OWNER
Credential: M.D.
Phone: 231-348-2828