| NPI | 1861701229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN JON BROWER Kssn Site Team Clinician 616-826-6063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MI 6801088412) |
| Enumeration Date | 2010-10-04 |
| Last Update Date | 2010-10-04 |