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General NPI Number Information
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NPI Number | 1790860278
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Entity Type | Organization
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Legal Business Name | CLARK TOWNSHIP - MACKINAC COUNTY
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 03/08/2013
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Provider Practice Location Address
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Address Line | 212 S MERIDIAN ST
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City | CEDARVILLE
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State | MI
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Zip | 49719
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Country | US
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Telephone | 906-484-2672
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Fax | 906-484-3199
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Provider Business Mailing Address
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Address Line | 207 N BLINDLINE ROAD
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City | CEDARVILLE
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State | MI
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Zip | 49719
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Country | US
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Telephone | 906-484-2672
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Fax | 906-484-3199
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Authorized Official
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Title or Position | TOWNSHIP CLERK
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Name | SUSAN J. RUTLEDGE
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Credential |
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Telephone | 906-484-2672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 341600000X
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Taxonomy Name | Ambulance
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License Number | 491001
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License Number State | MI
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