| NPI | 1376276345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT RUSSO Owner 616-256-8600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 171400000X | |
| 174200000X Meals | |
| 202D00000X | |
| 2083B0002X Preventive Medicine Obesity Medicine | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2023-02-28 |