NPI | 1811983000 |
---|---|
Doing Business As | SPECTRUM HEALTH- LAKE DRIVE SURGERY CENTER |
Entity Type | Organization |
Authorized Contact | DOUGALS D WELDAY VP Finance 616-391-2525 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MI 416835) |
Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
Enumeration Date | 2005-09-22 |
Last Update Date | 2014-07-29 |