Individual
MRS. BETH ANN BRODNICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSPT, CMLDT
Contact information
Practice address
4069 LAKE DR SE STE 114, GRAND RAPIDS, MI 49546-8816
(616) 267-8346
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501011240
MI
Other
Enumeration date
03/08/2018
Last updated
10/04/2021
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