MEDICARE: HOPE CLINIC FOR MUSCLE & JOINT PAIN PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1861800187
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOPE CLINIC FOR MUSCLE & JOINT PAIN PLLC

Provider Business Mailing Address
First Line	:	3271 RACQUET CLUB DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-4708
Country	:	US
Telephone Number	:	231-735-8006
Fax Number	:

Provider Business Practice Location Address
First Line	:	3271 RACQUET CLUB DR
Second Line	:
City	:	TRAVERSE CITY
State	:	MI
Zip	:	49684-4708
Country	:	US
Telephone Number	:	231-735-8006
Fax Number	:	231-735-8023

Authorized Official
Title or Position	:	MAJORITY PARTNER
Name	:	JAMES BERG
Credential	:	PA
Telephone Number	:	231-735-8006

Provider Enumeration Date	:	07/30/2014
Last Update Date	:	03/16/2021

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