| NPI | 1659012037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMIAH JOHNS Director 616-916-0774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0001X |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| 207PE0004X Emergency Medicine, Emergency Medical Services | |
| 2085N0904X | |
| 2085R0203X Radiology, Therapeutic Radiology | |
| Enumeration Date | 2022-04-07 |
| Last Update Date | 2022-09-07 |