| NPI | 1043075294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY L WACKSMAN Authorized Official 616-366-4234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 152W00000X Optometrist |
| 207RH0002X Internal Medicine Hospice and Palliative Medicine | |
| 2084P0805X Psychiatry & Neurology Geriatric Psychiatry | |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| 363LA2200X Nurse Practitioner Adult Health | |
| Enumeration Date | 2024-02-16 |
| Last Update Date | 2024-02-16 |