Provider Demographics
NPI:1801811369
Name:CHERRY BEND FAMILY CARE, PLC
Entity type:Organization
Organization Name:CHERRY BEND FAMILY CARE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LARA
Authorized Official - Middle Name:C
Authorized Official - Last Name:MADIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:231-929-7933
Mailing Address - Street 1:10223 E CHERRY BEND RD
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-7304
Mailing Address - Country:US
Mailing Address - Phone:231-929-7933
Mailing Address - Fax:
Practice Address - Street 1:10223 E CHERRY BEND RD
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7304
Practice Address - Country:US
Practice Address - Phone:231-929-7933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty