Individual
TIFFANY AMBER ELO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1771 KNAPP ST NE UNIT 2, GRAND RAPIDS, MI 49505-4501
(231) 510-1410
Mailing address
2000 LEONARD ST NE, GRAND RAPIDS, MI 49505-5837
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
5502008270
MI
Other
Enumeration date
06/09/2023
Last updated
06/09/2023
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