| NPI | 1194798959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY J MOSLEY Facility Administrator 616-949-2001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MI 416834) |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2020-08-22 |