Individual
TERESA A SELGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2410 WESTBROOK DR NW, GRAND RAPIDS, MI 49504-2343
(616) 490-0113
Mailing address
2410 WESTBROOK DR NW, GRAND RAPIDS, MI 49504-2343
(616) 490-0113
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704209118
MI
Other
Enumeration date
05/06/2019
Last updated
05/06/2019
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