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Individual

LORI LEE BULTINCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
4118 KALAMAZOO AVE SE, GRAND RAPIDS, MI 49508-3605
(616) 455-7300
Mailing address
2497 BLUEWATER CT SW, GRANDVILLE, MI 49418-1150
(616) 291-7301

Taxonomy

Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
5201006053
MI

Other

Enumeration date
03/14/2018
Last updated
03/14/2018
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