| NPI | 1265771448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK RADOM President 616-458-8063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2013-02-07 |
| Last Update Date | 2013-02-07 |