Individual
JENELLE CONOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
111 LAKESIDE DR NE, GRAND RAPIDS, MI 49503-3811
(616) 438-2425
Mailing address
6884 BYRON LAKES DR SW APT 1B, BYRON CENTER, MI 49315-9766
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
5502004636
MI
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
01/11/2019
Last updated
01/11/2019
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