| NPI | 1619147493 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE M GRZESZAK Provider 616-452-8923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208D00000X General Practice (Licence: MI 00714) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2010-01-19 |