| Organization Name: | THREE RIVERS HEALTH |
| NPI Number: | 1356696538 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM RUSSELL (CEO/PRESIDENT) |
| Mailing Address: | 711 S Health Pkwy Suite 3 Three Rivers |
| State: | MI US |
| Postal Code: | 490939387 |
| Phone Number: | 2692739687 |
| Fax Number: | 2692796461 |
| NPI Enumeration Date: | 07/13/2012 |
| NPI Last Update Date: | 07/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QX0100X |
| License Number: | 750020 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Occupational Medicine |
| Taxonomy Definition: | |