| NPI | 1144499195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL LYNN ALLEN Billing Manager 616-897-2142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101007920) |
| Enumeration Date | 2008-02-25 |
| Last Update Date | 2009-05-14 |