| NPI | 1356088801 |
|---|---|
| Other Name | JACQUELYN DEWAAL |
| Entity Type | Organization |
| Authorized Contact | JACQUELYN S DEWAAL Owner 269-365-3279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0700X Clinic/Center, Hearing and Speech |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2022-05-17 |