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Individual

JOSHUA KORNOELY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
428 BRIDGE ST NW, GRAND RAPIDS, MI 49504-5322
(616) 451-4284
(616) 451-4811
Mailing address
428 BRIDGE ST NW, GRAND RAPIDS, MI 49504-5322
(616) 451-4284
(616) 451-4811

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000233
MI

Other

Enumeration date
07/11/2012
Last updated
07/11/2012
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