Organization
PENNOCK HOSPITAL BOARD OF TRUSTEES
Active
Parent organization
PENNOCK HOSPITAL BOARD OF TRUSTEES
Organization subpart
Yes
Provider details
NPI number
Legal business name
PENNOCK HOSPITAL BOARD OF TRUSTEES
Authorized official
ROBERT DAVIS (DIRECTOR OF OPERATIONS)
(269) 945-1220
Entity
Organization
Contact information
Practice address
11275 SPRAGUE RD, DELTON, MI 49046-8493
(269) 623-5150
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
363LW0102X
Women's Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/23/2016
Last updated
03/23/2016
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