Graduated: 2020
NPI: 1881205045
Practice Locations (4)
607 DEWEY AVE NW, SUITE 300
Grand Rapids, MI 495045283
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.