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General NPI Number Information
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NPI Number | 1447423439
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Entity Type | Organization
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Legal Business Name | FEMME VITALE, PLC
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 431 UPTON DR EDGEWATER CENTER
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-1058
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Country | US
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Telephone | 269-982-3366
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Fax |
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Provider Business Mailing Address
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Address Line | 431 UPTON DR EDGEWATER CENTER
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City | SAINT JOSEPH
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State | MI
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Zip | 49085-1058
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Country | US
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Telephone | 269-982-3366
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. LAWRENCE CHRISTIE CAIRNS
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Credential | MD
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Telephone | 269-982-3366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 4301049836
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License Number State | MI
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