| NPI | 1912175472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WILLIAM NEWBERRY Owner 616-399-8650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MI 4301067531) |
| Enumeration Date | 2008-02-18 |
| Last Update Date | 2011-01-03 |