Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 2701187564 | MI |
NPI | 1861918864 |
---|---|
Provider Name | Summer Williams |
First Address | Grand Rapids, MI 49503-1323 |
Second Address | Grand Rapids, MI 49503-1323 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2017 |
Last Update Date | 21/08/2017 |