| NPI | 1003909524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL L. DENEFF VP Finance 616-242-0403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: MI 4301059802) |
| 207Q00000X Family Medicine (Licence: MI 4301042627) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2013-02-04 |