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General NPI Number Information
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NPI Number | 1598807737
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Entity Type | Organization
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Legal Business Name | ALLERGY & ASTHMA ASSOCIATES
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 07/28/2008
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Provider Practice Location Address
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Address Line | 1414 W FAIR AVE STE 108
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City | MARQUETTE
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State | MI
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Zip | 49855-5404
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Country | US
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Telephone | 906-225-3936
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Fax |
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Provider Business Mailing Address
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Address Line | 1414 W FAIR AVE STE 108
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City | MARQUETTE
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State | MI
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Zip | 49855-5404
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Country | US
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Telephone | 906-225-3936
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Fax |
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Authorized Official
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Title or Position | OFFICE COORDINATOR
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Name | LORI R FRALEY
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Credential |
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Telephone | 906-225-3936
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 4301054887
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License Number State | MI
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