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Individual

MRS. CARISSA ANN MORTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
285 N STATE ST, ZEELAND, MI 49464-1297
(616) 772-4641
Mailing address
607 DEWEY AVE NW STE 300, GRAND RAPIDS, MI 49504-7335
(616) 356-5000

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201007233
MI

Other

Enumeration date
02/24/2018
Last updated
02/24/2018
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