| NPI | 1194935387 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA ANNETTE WARREN Admin / Office Mgr 616-719-5939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI 4301080691) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2011-04-12 |