Organization
MED1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JULIENNE LITTLE D.O. (MEDICAL DIRECTOR)
(616) 459-6331
Entity
Organization
Contact information
Practice address
4433 BRETON RD SE, KENTWOOD, MI 49508-5273
(616) 281-6000
Mailing address
2683 CHATHAM WOODS DR SE, GRAND RAPIDS, MI 49546-6762
(517) 927-2653
Taxonomy
Speciality
Code
Description
License number
State
261QX0100X
Occupational Medicine Clinic/Center
Primary
4301036490
MI
Other
Enumeration date
11/22/2006
Last updated
08/22/2020
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