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Individual

MRS. JODI LYNN VANDERTUIG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
B.A

Contact information

Practice address
781 36TH ST SE, GRAND RAPIDS, MI 49548-2319
(616) 248-5159
Mailing address
137 ROLLINGWOOD DR, ROCKFORD, MI 49341-1193
(616) 633-3725

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary

Other

Enumeration date
02/09/2007
Last updated
07/08/2007
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