Individual
KATHRYN MARIE THELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1000 E PARIS AVE SE, SUITE 200, GRAND RAPIDS, MI 49546-3691
(616) 685-3450
(616) 685-3454
Mailing address
1000 E PARIS AVE SE STE 200, GRAND RAPIDS, MI 49546-8383
(616) 685-3450
(616) 685-3454
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601007795
MI
Other
Enumeration date
05/27/2016
Last updated
11/20/2019
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