Individual
GRACE K LEBLANC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1500 E SHERMAN BLVD, MUSKEGON, MI 49444-1849
(231) 672-3883
Mailing address
1560 E SHERMAN BLVD STE 240, MUSKEGON, MI 49444-1854
(231) 672-3883
(231) 672-3973
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
N34010023
MEDICARE PTAN
MI
Enumeration date
12/23/2011
Last updated
10/11/2023
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