Individual
MIRANDA ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1009 44TH ST SW STE 101, WYOMING, MI 49509-4480
(616) 828-4622
(616) 635-2552
Mailing address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-5224
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101021905
MI
Other
Enumeration date
06/22/2015
Last updated
06/04/2025
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