| NPI | 1386998755 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK ANTHONY LADO Member 616-325-1224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MI 5101014670) |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2023-08-14 |