Organization
BRIGHTWAVE PAIN THERAPY, PC
Active
Organization
BRIGHTWAVE PAIN THERAPY, PC
Active
Other names
BrightWave Pain Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD E WILLMAN DO (PRESIDENT)
(616) 608-5551
Entity
Organization
Contact information
Practice address
751 KENMOOR AVE SE, GRAND RAPIDS, MI 49546-2388
(616) 608-5551
Mailing address
751 KENMOOR AVE SE, GRAND RAPIDS, MI 49546-2388
(616) 608-5551
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
06/14/2019
Last updated
06/14/2019
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