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Organization

ELDER CARE OF WEST MICHIGAN PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATHY JO UECKER (BUSINESS MANAGER)
(269) 420-9404
Entity
Organization

Contact information

Practice address
6785 MYERS LAKE AVE NE, ROCKFORD, MI 49341-7416
(616) 366-4234
(616) 469-1118
Mailing address
4448 KOINONIA DR NE, GRAND RAPIDS, MI 49525-9332

Taxonomy

Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
363LG0600X
Gerontology Nurse Practitioner

Other

Enumeration date
02/15/2019
Last updated
05/02/2019
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