Individual
LAUREN MANKIVSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
100 MICHIGAN ST NE, SUITE A721, GRAND RAPIDS, MI 49503
(616) 267-7301
(616) 391-3044
Mailing address
5900 BYRON CENTER AVE SW, MEDICAL ADMINISTRATION, WYOMING, MI 49519-9606
(616) 252-3243
(616) 252-0260
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601007081
MI
Other
Enumeration date
05/09/2014
Last updated
08/28/2018
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