| NPI | 1023072550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PASUPATHY VADIVELU Administrator 616-249-3545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501005841) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2020-08-22 |