Individual
JOHN BERNAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
130 FULTON ST W, #111, GRAND RAPIDS, MI 49503-2682
(616) 831-6422
Mailing address
130 FULTON ST W, #111, GRAND RAPIDS, MI 49503-2682
(616) 831-6422
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000926
MI
Other
Enumeration date
10/20/2016
Last updated
10/20/2016
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