| NPI | 1891881066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN TARATUTA Office Manager 616-456-9553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: MI HS062163) |
| Additional Taxonomies | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2024-05-14 |