| Organization Name: | SPECTRUM HEALTH KELSEY |
| NPI Number: | 1356653182 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RYAN K JOHNSON (VP FINANCE) |
| Mailing Address: | 418 Washington St Lakeview |
| State: | MI US |
| Postal Code: | 488509806 |
| Phone Number: | 9893526435 |
| Fax Number: | 9893528451 |
| NPI Enumeration Date: | 07/09/2010 |
| NPI Last Update Date: | 04/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |