Individual
MR. GARRETT VAN WEATHERHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(517) 862-5924
Mailing address
1761 RESTORATION DR SW, BYRON CENTER, MI 49315-8180
(517) 862-5924
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301014124
MI
Other
Enumeration date
06/12/2014
Last updated
06/12/2014
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