| NPI | 1528254877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA SUE TUCK Manager Billing 616-866-2539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MI R0044045) |
| Enumeration Date | 2007-09-20 |
| Last Update Date | 2008-09-26 |