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

Crystal Lake Clinic PC

Organization Family Medicine Physician · NPI 1538543913

Crystal Lake Clinic PC is a Family Medicine Physician in Traverse City, Michigan. Registered with an NPI since 2015.

In the registry since
2015
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

1213 W Frnt ST
Traverse City, MI 49684-2317
Phone: (231) 715-3620
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1538543913
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Nielsen — President · (231) 882-9661
NPI enumeratedJuly 15, 2015
Last updated in NPPESJuly 15, 2015
Mailing address6227 Frankfort Hwy, Benzonia, MI 49616-8632

Other providers in Traverse City