| |
101 Sheldon Blvd Se, Grand Rapids, MI 49503 | |
(616) 776-2263 | |
Not Available |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 101 Sheldon Blvd Se, Grand Rapids, Michigan |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1013283852 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
100 Cherry St Se, Grand Rapids, MI 49503-4526 Ph: (616) 965-8200 | 101 Sheldon Blvd Se, Grand Rapids, MI 49503 Ph: (616) 776-2263 |