Individual
STU MCCALLISTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 481-6166
Mailing address
1534 GIDDINGS AVE SE, GRAND RAPIDS, MI 49507-2223
(616) 826-7876
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
MI
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
03/13/2023
Last updated
03/15/2023
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