Graduated: 2008
NPI: 1477110989
Practice Locations (3)
GRAND RAPIDS, MI 49525
6167068821
5242 PLAINFIELD AVE NE, SUITE E
GRAND RAPIDS, MI 495251084
5242 PLAINFIELD AVE NE E, OFFICE PLAINFIELD
GRAND RAPIDS, MI 495251084
6167068821
Source: CMS National Downloadable File, September 2026.