Graduated: 1993
NPI: 1518282631
Practice Locations (3)
2020 RAYBROOK ST SE, SUITE 102 6
GRAND RAPIDS, MI 495467776
6166449024
PO BOX, SUITE 140241
GRAND RAPIDS, MI 495140241
1876 MILLINS AVE NW
WALKER, MI 495342439
Source: CMS National Downloadable File, September 2026.