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Individual

MR. JOSEPH L GAGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
1450 LEONARD ST NE, GRAND RAPIDS, MI 49505-5515
(616) 774-8789
(616) 475-7570
Mailing address
736 UNION AVE NE, GRAND RAPIDS, MI 49503-1732
(616) 742-0185
(616) 897-5954

Taxonomy

Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6031014166
MI
164W00000X
Licensed Practical Nurse
4703077967
MI

Other

Enumeration date
12/26/2006
Last updated
05/29/2009
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