Individual
MRS. NICOLE MARIE PASTOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
17615 W MOORE, GRANT, MI 49327-9408
(231) 834-0208
Mailing address
5296 NEW HOLLAND ST, HUDSONVILLE, MI 49426-9565
(616) 813-9549
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT-6074
CA
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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