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Organization

LEGACY PRIMARY HEALTH LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VANESSA STEVENS (MANAGER)
(843) 990-1965
Entity
Organization

Contact information

Practice address
5165 NORTHLAND DR NE, GRAND RAPIDS, MI 49525-1015
(843) 990-1965
Mailing address
5165 NORTHLAND DR NE, GRAND RAPIDS, MI 49525-1015

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
11/07/2025
Last updated
11/07/2025
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