Graduated: 2006
NPI: 1124350657
Practice Locations (4)
100 MICHIGAN ST NE
Grand Rapids, MI 495032560
100 MICHIGAN AVE NE
GRAND RAPIDS, MI 495032560
30 S CAYUGA RD
WILLIAMSVILLE, NY 142216706
30 S CAYUGA RD
WILLIAMSVILLE, NY 142216728
Source: CMS National Downloadable File, September 2026.