Individual
CORTNEY CARLISLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9809 CHERRY VALLEY AVE SE STE D, CALEDONIA, MI 49316-9592
(269) 223-7786
Mailing address
1460 HIDDEN CREEK CIRCLE DR NE APT C, GRAND RAPIDS, MI 49505-5472
(218) 929-9595
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
4261
SC
225X00000X
Occupational Therapist
Primary
5201010171
MI
Other
Enumeration date
03/14/2014
Last updated
04/03/2018
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