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Individual

MS. LISA K. TOWNSEND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1135 WALKER AVE NW, GRAND RAPIDS, MI 49504-4062
(616) 328-4242
Mailing address
1135 WALKER AVE NW, GRAND RAPIDS, MI 49504-4062
(616) 328-4242

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L265059
MI
261QH0100X
Health Service Clinic/Center
L265059
MI

Other

Enumeration date
08/05/2015
Last updated
08/05/2015
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