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General NPI Number Information
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NPI Number | 1871331157
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Entity Type | Organization
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Legal Business Name | WEST MICHIGAN DEVELOPMENT A LLC
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Dates
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Enumeration Date | 07/19/2024
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 8251 WESTPARK WAY STE 200
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City | ZEELAND
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State | MI
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Zip | 49464-7906
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Country | US
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Telephone | 616-396-5855
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Fax |
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Provider Business Mailing Address
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Address Line | 8251 WESTPARK WAY STE 200
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City | ZEELAND
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State | MI
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Zip | 49464-7906
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Country | US
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Telephone | 616-290-0912
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Fax |
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | JAMIE KILLEBREW
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Credential |
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Telephone | 616-290-0912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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