Individual
JENNIFER KORNOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S.P.T., M.D.T.
Contact information
Practice address
3282 CLEAR VISTA CT NE, SUITE A, GRAND RAPIDS, MI 49525-9477
(616) 365-2709
(616) 365-3174
Mailing address
2120 43RD ST SE, SUITE 100, GRAND RAPIDS, MI 49508-3772
(616) 281-1144
(616) 281-1221
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501009512
MI
Other
Enumeration date
11/24/2006
Last updated
07/08/2007
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