Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Crystal Lake Clinic PC

Organization Family Medicine Physician · NPI 1134491731

Crystal Lake Clinic PC is a Family Medicine Physician in Manistee, Michigan. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1806 E Parkdale Ave Ste 2
Manistee, MI 49660-9364
Phone: (231) 882-9661
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1134491731
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Nielsen — President · (231) 882-9661
NPI enumeratedJanuary 30, 2012
Last updated in NPPESJanuary 30, 2012
Mailing address6227 Frankfort Hwy, Benzonia, MI 49616-8632

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