Individual
JULIE TIEDGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2249 WEALTHY ST SE STE 120, EAST GRAND RAPIDS, MI 49506-3052
(616) 391-4650
(616) 486-0134
Mailing address
2249 WEALTHY ST SE STE 120, EAST GRAND RAPIDS, MI 49506-3052
(616) 391-4650
(616) 486-0134
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501011134
MI
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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