| Organization Name: | KEWEENAW HOLISTIC FAMILY MEDICINE, PC |
| NPI Number: | 1275783342 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JILL E. KALCICH (PRESIDENT) |
| Mailing Address: | 56611 Calumet Ave Calumet |
| State: | MI US |
| Postal Code: | 499131603 |
| Phone Number: | 9063371844 |
| Fax Number: | |
| NPI Enumeration Date: | 09/25/2008 |
| NPI Last Update Date: | 07/21/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | 4704208143 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |