| NPI | 1396190138 |
|---|---|
| Doing Business As | COREWELL HEALTH PENNOCK HOSPITAL FAMILY MEDICINE - STATE ST |
| Doing Business As | SPECTRUM HEALTH PENNOCK FAMILY, INTERNAL & PEDIATRIC MEDICINE - HASTIN |
| Entity Type | Organization |
| Authorized Contact | JOHN SELLA Controller 616-802-0206 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2023-08-23 |