Provider First Line Business Practice Location Address:
COREWELL HEALTH WEST ID CLINIC
Provider Second Line Business Practice Location Address:
230 MICHIGAN STREET, SUITE 230
Provider Business Practice Location Address City Name:
GRAND RAPIDS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
616-774-2822
Provider Business Practice Location Address Fax Number:
616-391-8665
Provider Enumeration Date:
06/24/2024