Individual
JACOB LANDRETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1315 GLADSTONE DR SE, GRAND RAPIDS, MI 49506-3949
(616) 890-4298
Mailing address
2013 EASTCASTLE DR SE STE B, GRAND RAPIDS, MI 49508-8873
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/06/2024
Last updated
05/06/2024
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