| NPI | 1972550580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY RUCH Billing Cycle Analyst 616-844-4510 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207V00000X Obstetrics & Gynecology | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2020-12-17 |