| NPI | 1932490885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY POHOLSKI Director 616-975-1845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2011-04-27 |
| Last Update Date | 2019-04-02 |