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General NPI Number Information
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NPI Number | 1003292905
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Entity Type | Organization
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Legal Business Name | ALPENA REDICARE WALK-IN CLINIC, PLLC
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Dates
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Enumeration Date | 08/03/2015
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Last Update Date | 08/03/2015
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Provider Practice Location Address
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Address Line | 1691 M 32 W SUITE 2
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City | ALPENA
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State | MI
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Zip | 49707-8210
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Country | US
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Telephone | 517-819-9279
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Fax |
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Provider Business Mailing Address
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Address Line | 8607 US HIGHWAY 23 S
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City | OSSINEKE
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State | MI
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Zip | 49766-9563
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JESSICA GLENN-BEATTY
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Credential | MD
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Telephone | 517-819-9279
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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