| NPI | 1407313802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISABETH LACEY Manager, Enrollment Services 616-486-6630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2019-02-22 |