Individual
KRISTY L VANWORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3908 112TH AVE, HOLLAND, MI 49424-8608
(616) 772-1627
Mailing address
3908 112TH AVE, HOLLAND, MI 49424-8608
(616) 772-1627
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502001577
MI
Other
Enumeration date
04/22/2015
Last updated
04/22/2015
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