Organization
GRAND VALLEY STATE UNIVERSITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAIN HATZEL (ASSOCIATE PROFESSOR)
(616) 331-8538
Entity
Organization
Contact information
Practice address
1 CAMPUS DR, ALLENDALE, MI 49401-9401
(616) 331-5000
Mailing address
4932 W CAMPUS DR, UNIT B14, ALLENDALE, MI 49401-8822
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/29/2015
Last updated
01/29/2015
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