Organization
PATHOLOGY LABORATORY, P.C.
Active
Other names
PATHOLOGY LABORATORY, P.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM A. MILLS M.D. (PRESIDENT)
(616) 530-3344
Entity
Organization
Contact information
Practice address
2620 HORIZON DRIVE SE, SUITE 100, GRAND RAPIDS, MI 49546-7936
(616) 530-3344
(616) 530-0575
Mailing address
2620 HORIZON DR SE, SUITE 100, GRAND RAPIDS, MI 49546-7520
(616) 530-3344
(616) 530-0575
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
23D0380021
MI
291U00000X
Clinical Medical Laboratory
Primary
23D0380021
MI
Other
Enumeration date
12/01/2005
Last updated
06/23/2014
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