| The Salvation Army Booth Clinic | |
|
1215 Fulton St E Grand Rapids MI 49503-3849 | |
| (616) 459-9468 | |
| (616) 459-7223 |
| Full Name | The Salvation Army Booth Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 1215 Fulton St E, Grand Rapids, Michigan |
| Authorized Official Name and Position | Chris Shea (CEO) |
| Authorized Official Contact | 6167762120 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Salvation Army Booth Clinic 100 Cherry St Se Grand Rapids MI 49503-4526 Ph: (616) 965-8200 | The Salvation Army Booth Clinic 1215 Fulton St E Grand Rapids MI 49503-3849 Ph: (616) 459-9468 |
| NPI Number | 1063586816 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 10/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063586816 | NPI | - | NPPES |
| 231857 | Other | MI | FACILITY NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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