Organization
DAVIS L DALTON DO PC
Active
Other names
DAVIS L DALTON DO
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI K BOWLING (OFFICE MANAGER)
(616) 241-5000
Entity
Organization
Contact information
Practice address
2000 BURTON ST SE, GRAND RAPIDS, MI 49506-4670
(616) 241-5000
Mailing address
2000 BURTON ST SE, GRAND RAPIDS, MI 49506-4670
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
5101008097
MI
Other
Enumeration date
03/20/2008
Last updated
03/31/2008
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