| NPI | 1336201565 |
|---|---|
| Doing Business As | EXECUTIVE FAMILY AND SPORTS |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER ZIELINSKI President 616-734-0335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101013068) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2007-12-18 |