Registry details
Type
Individual
Primary specialty
Radiology, Diagnostic Radiology
Enumerated
Apr 3, 2025
License(s)
4351054574 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 100 MICHIGAN ST NE STE A601 | Grand Rapids, MI 49503-2560 | 616-391-3777 |
| MAILING | 100 MICHIGAN ST NE STE A601 | Grand Rapids, MI 49503-2560 | 616-391-3777 |
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