Provider Demographics
NPI:1346831468
Name:PERSONALIZED FAMILY CARE PLC
Entity Type:Organization
Organization Name:PERSONALIZED FAMILY CARE PLC
Other - Org Name:INTEGRATIVE FAMILY MEDICINE AND URGENT CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:GALLIWAY
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:810-569-9514
Mailing Address - Street 1:6232 ATLAS VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7804
Mailing Address - Country:US
Mailing Address - Phone:810-569-9514
Mailing Address - Fax:
Practice Address - Street 1:1537 E HILL RD STE 400
Practice Address - Street 2:
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-5190
Practice Address - Country:US
Practice Address - Phone:810-333-7309
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Single Specialty