| NPI | 1558377192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH BOLTINGHOUSE Office Manager 616-233-0933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 5101009309) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2008-03-18 |