Graduated: 2018
NPI: 1164910550
Practice Locations (3)
544 MYRTLE ST NW, APT 2
GRAND RAPIDS, MI 495043293
544 MYRTLE ST NW APT, SUITE 2
GRAND RAPIDS, MI 495043293
1861 RW BERENDS DR SW
WYOMING, MI 495194955
Source: CMS National Downloadable File, September 2026.