Organization
ADO MEDICAL OF KANSAS, PA
Active
Other names
ADHD Online
Organization subpart
No
Provider details
NPI number
Authorized official
TIM GUTWALD (GENERAL COUNSEL)
(616) 498-8102
Entity
Organization
Contact information
Practice address
4555 WILSON AVE SW STE 1, GRANDVILLE, MI 49418-2370
(616) 229-2935
Mailing address
625 KENMOOR AVE SE STE 301, GRAND RAPIDS, MI 49546-2395
(616) 229-2935
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/24/2024
Last updated
01/24/2024
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