Individual
MARY CAROL VANDER WAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
13712 32ND AVE, MARNE, MI 49435-9727
(616) 677-3633
(616) 677-5330
Mailing address
13712 32ND AVE, MARNE, MI 49435-9727
(616) 677-3633
(616) 677-5330
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704118232
MI
Other
Enumeration date
06/08/2009
Last updated
06/08/2009
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