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General NPI Number Information
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NPI Number | 1518152735
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Entity Type | Organization
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Legal Business Name | AQUINAS COLLEGE INC
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Dates
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Enumeration Date | 09/11/2007
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Last Update Date | 09/11/2007
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Provider Practice Location Address
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Address Line | 1607 ROBINSON RD SE WEGE CENTER
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-1741
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Country | US
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Telephone | 616-632-2970
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Fax | 616-732-4580
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Provider Business Mailing Address
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Address Line | 1607 ROBINSON RD SE WEGE CENTER
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City | GRAND RAPIDS
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State | MI
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Zip | 49506-1741
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Country | US
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Telephone | 616-632-2970
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Fax | 616-732-4580
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Authorized Official
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Title or Position | CLINIC DIRECTOR
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Name | KIMBERLY TEXLEY-QUIGG
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Credential | RNC,NP
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Telephone | 616-632-2969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 4704124474
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License Number State | MI
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