Individual
CASSANDRA JEAN FASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3492 LAKE DR SE, GRAND RAPIDS, MI 49546-4338
(616) 957-4057
Mailing address
3492 LAKE DR SE, GRAND RAPIDS, MI 49546-4338
(616) 957-4057
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
11/08/2013
Last updated
11/08/2013
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