| NPI | 1124519707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM JOSEPH RUSH Owner 616-780-7389 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301091218) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301091218) |
| 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine (Licence: MI 4301091218) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| Enumeration Date | 2018-05-19 |
| Last Update Date | 2023-05-12 |