| NPI | 1669651097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS FOWLER Owner 616-355-2930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MI 5501009059) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2015-09-25 |