| NPI | 1164461943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID T OTTENBAKER President 616-846-8540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207R00000X Internal Medicine | |
| 208000000X Pediatrics | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2025-09-11 |