Individual
MARY M. LOVELACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 942-2110
Mailing address
309 PAGE ST NE, GRAND RAPIDS, MI 49505-5068
(989) 335-0437
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202007920
MI
Other
Enumeration date
12/27/2017
Last updated
12/27/2017
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