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NPI Code Detail

MEDICARE: SPECTRUM HEALTH UNITED

MEDICARE: SPECTRUM HEALTH UNITED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133N00000XNutritionist
2133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1659643039
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPECTRUM HEALTH UNITED
Provider Business Mailing Address
First Line : 300 N PATTERSON RD
Second Line :
City : REED CITY
State : MI
Zip : 49677-8041
Country : US
Telephone Number : 231-832-8555
Fax Number :
Provider Business Practice Location Address
First Line : 407 S NELSON ST
Second Line :
City : GREENVILLE
State : MI
Zip : 48838-2138
Country : US
Telephone Number : 616-754-6407
Fax Number :
Authorized Official
Title or Position : DIRECTOR HEALTHY LIFESTYLES
Name : MS. JODIE FABER
Credential :
Telephone Number : 616-754-6407
Provider Enumeration Date : 02/01/2012
Last Update Date : 02/01/2012

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Directions to “SPECTRUM HEALTH UNITED ” Practice Location

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