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General NPI Number Information
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NPI Number | 1467470492
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Entity Type | Organization
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Legal Business Name | WESTERN MICHIGAN UNIVERSITY
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 1903 W MICHIGAN AVE
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City | KALAMAZOO
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State | MI
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Zip | 49008-5200
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Country | US
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Telephone | 269-387-4303
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Fax | 269-387-2944
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Provider Business Mailing Address
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Address Line | 1903 W MICHIGAN AVE
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City | KALAMAZOO
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State | MI
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Zip | 49008-5200
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Country | US
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Telephone | 269-387-4303
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Fax | 269-387-2944
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. CAROL EDDY
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Credential | MPA
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Telephone | 269-387-3280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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