| NPI | 1326495326 |
|---|---|
| Doing Business As | SPECTRUM HEALTH PENNOCK |
| Entity Type | Organization |
| Authorized Contact | DEIDRE WELLER Controller 269-948-3122 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2016-05-19 |