Individual
MRS. AMY ELAINE KOORNDYK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3584 FAIRLANES AVE SW, GRANDVILLE, MI 49418-1583
(616) 222-5300
Mailing address
3584 FAIRLANES AVE SW, GRANDVILLE, MI 49418-1583
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703098808
MI
Other
Enumeration date
09/15/2023
Last updated
09/15/2023
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