Healthcare Provider Details

I. General information

NPI: 1174389605
Provider Name (Legal Business Name): TRUELINE HEALTH CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 RAYBROOK ST SE STE 200
GRAND RAPIDS MI
49546-7718
US

IV. Provider business mailing address

6757 CASCADE RD SE PMB 89
GRAND RAPIDS MI
49546-6849
US

V. Phone/Fax

Practice location:
  • Phone: 616-386-4260
  • Fax:
Mailing address:
  • Phone: 616-648-0095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: NANCY TUOHY
Title or Position: CHIEF ADMINISTRATOR
Credential:
Phone: 616-648-0095