Individual
MS. LEAH CAMERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1100 E PARIS AVE SE, GRAND RAPIDS, MI 49546-8367
(616) 531-5407
Mailing address
1100 E PARIS AVE SE, GRAND RAPIDS, MI 49546-8367
(616) 531-5407
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502003631
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5502003631
STATE LICENSE
MI
Enumeration date
11/15/2012
Last updated
11/15/2012
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