ProviderBusinessMailingAddressFaxNumber = '6167719779'
| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1073949038 | BOOMGAARD | ANDREA | | | 516 CHERRY ST. SE | GRAND RAPIDS | MI | 49503 |
| 1922349885 | EBELS | LINDSAY | | | 516 CHERRY ST SE | GRAND RAPIDS | MI | 495034702 |
| 1639418288 | GENZINK | MELISTA | DEE | | 516 CHERRY ST SE | GRAND RAPIDS | MI | 495034702 |
| 1114268075 | GRAGJEVI | ELLEN | | | 516 CHERRY ST SE | GRAND RAPIDS | MI | 495034702 |
| 1316257108 | JOHNSON | SHARON | MARIE | | 516 CHERRY ST SE | GRAND RAPIDS | MI | 495034702 |
| 1407185077 | MCSHANE | TIMOTHY | W | | 516 CHERRY ST SE | GRAND RAPIDS | MI | 495034702 |
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