# MED1

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275608234
- **Authorized official:** DR. JULIENNE LITTLE D.O. (MEDICAL DIRECTOR)
- **Authorized official phone:** (616) 459-6331

## Contact information

- **Practice address:** 4433 BRETON RD SE, KENTWOOD, MI 49508-5273
- **Practice address phone:** (616) 281-6000
- **Mailing address:** 2683 CHATHAM WOODS DR SE, GRAND RAPIDS, MI 49546-6762
- **Mailing address phone:** (517) 927-2653

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | 4301036490 | MI | Yes |

## Other

- **Enumeration date:** 11/22/2006
- **Last updated:** 08/22/2020