Organization
CHERRY STREET SERVICES, INC
Active
Other names
Grand Rapids Pediatric
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS SHEA (CEO)
(616) 776-2120
Entity
Organization
Contact information
Practice address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
(616) 940-5366
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
(616) 940-5366
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301036769
MI
Other
Enumeration date
12/06/2006
Last updated
10/19/2012
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