Graduated: 2020
NPI: 1396342796
Practice Locations (3)
607 DEWEY AVE NW, SUITE 300
GRAND RAPIDS, MI 495045283
625 KENMOOR AVE SE, SUITE 100
GRAND RAPIDS, MI 495462395
6016 LOVERS LN, SUITE 3
PORTAGE, MI 490023050
Source: CMS National Downloadable File, September 2026.