| Neurocore | |
|
3148 44th St Sw Grandville MI 49418 | |
| (800) 600-4096 | |
| (800) 606-8839 |
| Full Name | Neurocore |
|---|---|
| Speciality | Psychologist |
| Location | 3148 44th St Sw, Grandville, Michigan |
| Authorized Official Name and Position | Timothy Royer (PROVIDER/AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 8006004096 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Neurocore 201 Monroe Ave Nw Suite 300 Grand Rapids MI 49503 Ph: (800) 600-4096 | Neurocore 3148 44th St Sw Grandville MI 49418 Ph: (800) 600-4096 |
| NPI Number | 1013294628 |
|---|---|
| Provider Enumeration Date | 11/10/2011 |
| Last Update Date | 02/21/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013294628 | NPI | - | NPPES |
| 0D14689 | Other | MI | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 6301009353 (Michigan) | Primary |
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