Provider Demographics
NPI:1801074646
Name:GRAND TRAVERSE COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:GRAND TRAVERSE COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-922-2703
Mailing Address - Street 1:2325 GARFIELD RD N
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-5178
Mailing Address - Country:US
Mailing Address - Phone:231-922-2703
Mailing Address - Fax:231-922-2719
Practice Address - Street 1:2325 GARFIELD RD N
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-5178
Practice Address - Country:US
Practice Address - Phone:231-922-2703
Practice Address - Fax:231-922-2719
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRAND TRAVERSE COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010287252083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty