NPI 1326649120

Source Medical Solutions

Organisation General Practice Physician Grand Rapids, MI

Practice location

Address: 625 Kenmoor Ave SE STE 301, Grand Rapids, MI 49546-2395
Phone: (616) 916-8063

Authorised official

Name: Thomas Henke
Title: Owner/Physician
Phone: (616) 916-8063

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

Other General Practice providers in Michigan →

Registry record

NPI: 1326649120
Entity type: Organization
NPI issued: 6 Nov 2020
Record last updated: 23 Jan 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.