Crystal Lake Clinic P.C.

LBN: Crystal Lake Clinic P.C.
Crystal Lake Clinic P.C. is an health care organization with primary practice located at 1225 W Front St Suite C, Traverse City MI 49684-2368. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Crystal Lake Clinic P.C. can be contacted via phone (231) 715-3601, or through Nielsen, Richard C via phone (231) 882-9661.

Contact Information

Primary practice address
1225 W Front St Suite C Traverse City MI 49684-2368
Phone: (231) 715-3601
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Nielsen, Richard C Doctor of Medicine (MD)
Phone: (231) 882-9661

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1679957617
LBN Legal business name Crystal Lake Clinic P.C.
DBA Doing business as
Authorized official Nielsen, Richard C Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 18th, 2015
Last updated Jul 18th, 2015 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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