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Individual

GINGER K BIESBROCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2332 ALPINE AVE NW, GRAND RAPIDS, MI 49544-1955
(616) 391-6220
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601002942
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1982921
MI
01
970020995
RAILROAD MEDICARE
MI
Enumeration date
11/07/2005
Last updated
08/12/2014
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