Individual
GRACE MIERENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
2770 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-8614
(616) 267-7000
Mailing address
820 MEADOW DR, WAYLAND, MI 49348-1369
(269) 680-9159
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002645
MI
Other
Enumeration date
09/14/2020
Last updated
11/08/2024
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