Individual
AMY GRACE CARLSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1701 S 11TH ST, KALAMAZOO, MI 49009-1775
(269) 375-2020
Mailing address
1207 JENKS BLVD, KALAMAZOO, MI 49006-2105
(269) 823-3707
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502002404
MI
Other
Enumeration date
02/02/2016
Last updated
02/02/2016
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