| NPI | 1770696379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE S VANDERVEEN President 616-393-2190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YS0123X Otolaryngology, Facial Plastic Surgery |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-08-22 |