Individual
JAMIN SHORT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
834 GRIGGS ST SE, GRAND RAPIDS, MI 49507-2730
(360) 356-2158
Mailing address
834 GRIGGS ST SE, GRAND RAPIDS, MI 49507-2730
(360) 356-2158
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/22/2016
Last updated
08/22/2016
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