Provider Demographics
NPI:1811009871
Name:SOUTH CEDAR OSTEOPATHIC SERVICES, P.C.
Entity Type:Organization
Organization Name:SOUTH CEDAR OSTEOPATHIC SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HESS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:517-882-6643
Mailing Address - Street 1:3955 PATIENT CARE WAY STE B
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4271
Mailing Address - Country:US
Mailing Address - Phone:517-882-6643
Mailing Address - Fax:517-882-1949
Practice Address - Street 1:3955 PATIENT CARE WAY STE B
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4271
Practice Address - Country:US
Practice Address - Phone:517-882-6643
Practice Address - Fax:517-882-1949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty