Organization
MED1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY ALICE EHRLICH RN,BSN,MS (EXECUTIVE VICE PRESIDENT)
(616) 459-6331
Entity
Organization
Contact information
Practice address
1140 MONROE AVE NW, SUITE 150, GRAND RAPIDS, MI 49503-1055
(616) 459-6331
Mailing address
1140 MONROE AVE NW, SUITE 150, GRAND RAPIDS, MI 49503-1055
(616) 459-6331
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
5501011266
MI
Other
Enumeration date
06/02/2008
Last updated
06/02/2008
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