Individual
PAM MOHRHARDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
800 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-5848
(616) 456-6135
(616) 771-9779
Mailing address
16253 136TH AVE, NUNICA, MI 49448-9648
(616) 847-0651
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703042784
MI
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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