| Organization Name: | MED1 |
| NPI Number: | 1275608234 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JULIENNE LITTLE (MEDICAL DIRECTOR) |
| Mailing Address: | 4433 Breton Rd Se Kentwood |
| State: | MI US |
| Postal Code: | 495085273 |
| Phone Number: | 6162816000 |
| Fax Number: | |
| NPI Enumeration Date: | 11/22/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QX0100X |
| License Number: | 4301036490 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Occupational Medicine |
| Taxonomy Definition: | |