Individual
ALEXIS CLAIRE GANOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1490 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(855) 407-7575
(616) 940-8151
Mailing address
2900 SWANSEA DR SE, GRAND RAPIDS, MI 49546-5672
(734) 365-1512
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
11/12/2020
Last updated
11/12/2020
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