| NPI | 1093577108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIM GUTWALD General Counsel 616-498-8102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103TC0700X Psychologist Clinical |
| Enumeration Date | 2024-01-24 |
| Last Update Date | 2024-01-24 |