Organization
GRAND RAPIDS PAIN FREE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK RADOM (PRESIDENT)
(616) 458-8063
Entity
Organization
Contact information
Practice address
831 FULLER AVE NE, GRAND RAPIDS, MI 49503-1901
(616) 458-8063
(616) 458-6711
Mailing address
831 FULLER AVE NE, GRAND RAPIDS, MI 49503-1901
(616) 458-8063
(616) 458-6711
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
02/07/2013
Last updated
02/07/2013
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