Individual
MICHAEL ALLEN VANEERDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1359 EMERALD AVE NE, GRAND RAPIDS, MI 49505-5226
(574) 612-4458
Mailing address
1359 EMERALD AVE NE, GRAND RAPIDS, MI 49505-5226
(574) 612-4458
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7501009828
MI
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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