| NPI | 1194967554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THADDEUS P. SRUTWA Owner 616-229-3295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301045363) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: MI 4301045363) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2019-07-08 |