104100000X
Grand Haven, MI
Specialty
104100000X
Credential
LMSW
NPI
1124574264
15100 Whittaker Way, Grand Haven, MI 49417
(616) 935-6200Confirm current license and practice information on the official CMS NPI registry.
View NPI RecordThis surgeon specializes in 104100000x procedures performed in an outpatient ambulatory surgical setting.
NUCC Taxonomy: 104100000X