| NPI | 1275937625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL JUGAN Owner 616-780-7489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MI 4301091286) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2018-09-05 |