| NPI | 1790067015 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK DANIEL STANTON General Manager 616-863-9482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MI 4301059449) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2011-09-13 |