| NPI | 1003924739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA MARTIN Billing 616-453-6329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MI 4301066494) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: MI 4301074294) |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: MI 4301074445) | |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2016-06-07 |