Organization
VICTORY INSTITUTE FOR WEIGHT MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW S BLAIR D. O. (MEMBER)
(616) 457-3600
Entity
Organization
Contact information
Practice address
2093 HEALTH DR SW, SUITE 302, WYOMING, MI 49519-9691
(616) 457-3600
(616) 284-5208
Mailing address
2093 HEALTH DR SW, SUITE 302, WYOMING, MI 49519-9691
(616) 457-3600
(616) 284-5208
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
133V00000X
Registered Dietitian
—
—
207RB0002X
Obesity Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
10/28/2008
Last updated
10/28/2008
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