| NPI | 1689731507 |
|---|---|
| Doing Business As | SCHOOL BASED PROGRAM MEDICAL |
| Entity Type | Organization |
| Authorized Contact | CHRIS SHEA CEO 616-776-2120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 2800317) |
| Additional Taxonomies | 163W00000X Registered Nurse |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2012-10-19 |