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General NPI Number Information
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NPI Number | 1093349698
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Entity Type | Organization
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Legal Business Name | MUNSON HEALTHCARE GRAYLING
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Dates
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Enumeration Date | 02/24/2020
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 1321 S MOUNT TOM RD
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City | MIO
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State | MI
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Zip | 48647-9518
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Country | US
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Telephone | 989-344-5820
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Fax | 231-392-7338
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Provider Business Mailing Address
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Address Line | 1321 S MOUNT TOM RD
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City | MIO
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State | MI
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Zip | 48647-9518
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Country | US
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Telephone | 989-344-5820
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Fax | 231-392-7338
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Authorized Official
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Title or Position | COO MUNSON PHYSICIAN NETWORK
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Name | BONNIE KRUSZKA
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Credential |
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Telephone | 231-935-4995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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