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Individual

CAROLINE JUSTINE EASTMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
COTA/L

Contact information

Practice address
3300 36TH ST SE, GRAND RAPIDS, MI 49512-2810
(616) 942-2110
Mailing address
4342 BELGRAVE ST, WAYLAND, MI 49348-9189
(616) 822-0913

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
418642
MI

Other

Enumeration date
04/05/2019
Last updated
09/04/2019
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