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 1417386145

Crystal Lake Clinic, PC provides Family Medicine Physician services in Empire, Michigan. Registered with an NPI since 2013.

In the registry since
2013
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

9975 W Ottawa Ave
Empire, MI 49630-9618 Not confirmed with CMS for 12 years — call before visiting
Phone: (231) 882-9616
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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 number1417386145
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Richard Nielsen — President · (231) 882-9661
NPI enumeratedNovember 4, 2013
Last updated in NPPESNovember 4, 2013
Mailing address6227 Frankfort Hwy, Benzonia, MI 49616-8632

Other providers in Empire