Organization Name: | PREVENTIVE CARE CENTER PLC |
NPI Number: | 1700214756 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SETH R BERNARD (MEMBER) |
Mailing Address: | 2284 S Ballenger Hwy Ste H Flint |
State: | MI US |
Postal Code: | 485033446 |
Phone Number: | 8102335211 |
Fax Number: | 8102335740 |
NPI Enumeration Date: | 10/29/2013 |
NPI Last Update Date: | 10/29/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |