Individual
JAINYA SANNOH
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
364 SUMMER CIR SE, GRAND RAPIDS, MI 49548-7021
(616) 308-0608
Mailing address
364 SUMMER CIR SE, GRAND RAPIDS, MI 49548-7021
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703111106
MI
Other
Enumeration date
08/06/2026
Last updated
08/06/2026
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