Individual
KAITLIN EZINGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
150 JEFFERSON AVE SE, SUITE 100, GRAND RAPIDS, MI 49503-4306
(616) 284-3690
(616) 301-1320
Mailing address
607 DEWEY AVE NW, SUITE 300, GRAND RAPIDS, MI 49504-7335
(616) 356-5000
(616) 356-5001
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501016809
MI
Other
Enumeration date
08/07/2014
Last updated
08/07/2014
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