| Organization Name: | ASPIRUS KEWEENAW |
| NPI Number: | 1831444744 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHANE M JACQUES (CFO) |
| Mailing Address: | 205 Osceola St Laurium |
| State: | MI US |
| Postal Code: | 499132134 |
| Phone Number: | 9063376500 |
| Fax Number: | 9063376597 |
| NPI Enumeration Date: | 07/17/2012 |
| NPI Last Update Date: | 02/15/2013 |
| 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: | |