| NPI | 1790410991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BENNETT President 616-290-1876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VF0040X Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery |
| Enumeration Date | 2022-07-21 |
| Last Update Date | 2024-05-27 |