Organization
PATHOLOGY LABORATORY, P.C.
Active
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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