Individual
NIKKI R PANTELIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1490 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(616) 279-5349
Mailing address
1490 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
04/16/2020
Last updated
04/16/2020
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