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General NPI Number Information
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NPI Number | 1134207624
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Entity Type | Organization
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Legal Business Name | IONIA ASSOCIATES LLC
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 09/12/2017
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Provider Practice Location Address
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Address Line | 330 LOVELL ST
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City | IONIA
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State | MI
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Zip | 48846-9706
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Country | US
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Telephone | 616-527-5732
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Fax | 616-527-5720
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Provider Business Mailing Address
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Address Line | 330 LOVELL ST
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City | IONIA
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State | MI
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Zip | 48846-9706
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Country | US
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Telephone | 616-527-5732
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Fax | 616-527-5720
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CHERYL HILDEBRANDT
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Credential |
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Telephone | 616-527-5732
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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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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