Individual
MR. JOEL ANDREW VANDER WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
3863 LAKE MICHIGAN DR NW, GRAND RAPIDS, MI 49534
(616) 735-4545
(616) 735-6344
Mailing address
1465 64TH ST SW, BYRON CENTER, MI 49315
(616) 257-3014
(616) 735-6344
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501010049
—
Other
Enumeration date
06/15/2007
Last updated
07/08/2007
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