| NPI | 1104985001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONYA D WILSON Provider Credentialing 616-363-7867 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0004X Emergency Medicine, Emergency Medical Services |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2017-03-14 |