Individual
MELISSA DAVISSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6505 CHERRY MEADOW DR SE, CALEDONIA, MI 49316-9484
(166) 891-8770
(616) 891-3504
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 552-6139
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
5601009495
MI
363A00000X
Physician Assistant
5601009495
MI
Other
Enumeration date
09/30/2019
Last updated
08/25/2021
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