12TH STREET PLLC
Organization (NPI-2)
Active
Internal Medicine
Provider Information
- NPI Number
1790470409- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 3587 12TH ST, WAYLAND, MI, 493489569
- Phone
- (616) 648-4933
Specialties & Taxonomies
Pediatrics
Internal Medicine
Primary
All Addresses
MAILING
3587 12TH ST
WAYLAND, MI, 493489569