Graduated: 1985
NPI: 1427168285
Practice Locations (3)
640 3 MILE RD NW, SUITE 101
GRAND RAPIDS, MI 495448209
6167858900
640 THREE MILE RD NE, SUITE 101
GRAND RAPIDS, MI 495448209
640 THREE MILE RD NORTHWEST, SUITE 101
GRAND RAPIDS, MI 495448209
Source: CMS National Downloadable File, September 2026.