| |
540 Cherry St Se Grand Rapids MI 49503-4748 | |
(616) 776-2120 | |
(616) 772-2122 |
Full Name | |
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Speciality | Family Medicine |
Location | 540 Cherry St Se, Grand Rapids, Michigan |
Authorized Official Name and Position | Linda Constantino (FINANCE DIRECTOR) |
Authorized Official Contact | 6167762120 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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100 Cherry Street Se Grand Rapids MI 49503 Ph: (616) 776-2120 | 540 Cherry St Se Grand Rapids MI 49503-4748 Ph: (616) 776-2120 |
NPI Number | 1952699415 |
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Provider Enumeration Date | 07/19/2011 |
Last Update Date | 07/19/2011 |
Identifier | Type | State | Issuer |
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1952699415 | NPI | - | NPPES |
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