Provider Demographics
NPI:1821347741
Name:SPRING ARBOR UNIVERSITY
Entity Type:Organization
Organization Name:SPRING ARBOR UNIVERSITY
Other - Org Name:HOLTON HEALTH AND WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSOCIATE V.P. FOR STUDENT DEVELOPM
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:VANDERHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-750-6367
Mailing Address - Street 1:106 EAST MAIN STREET
Mailing Address - Street 2:C/O SPRING ARBOR UNIVERSITY
Mailing Address - City:SPRING ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49283-9701
Mailing Address - Country:US
Mailing Address - Phone:517-750-6352
Mailing Address - Fax:517-750-6625
Practice Address - Street 1:106 EAST MAIN STREET
Practice Address - Street 2:SPRING ARBOR UNIVERSITY
Practice Address - City:SPRING ARBOR
Practice Address - State:MI
Practice Address - Zip Code:49283-9701
Practice Address - Country:US
Practice Address - Phone:517-750-6352
Practice Address - Fax:517-750-6625
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPRING ARBOR UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-06
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty