Individual
MICHELLE MINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1098 LAKE PARK DR, GRAND BLANC, MI 48439-8073
(616) 644-8604
Mailing address
1098 LAKE PARK DR, GRAND BLANC, MI 48439-8073
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005828
MI
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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