Individual
KRISTINA FOWLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
(616) 840-8558
Mailing address
235 WEALTHY ST SE, GRAND RAPIDS, MI 49503-5247
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730133463
—
MI
Enumeration date
02/27/2018
Last updated
02/27/2018
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