Individual
MAREENA LYNN TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
(616) 855-8976
Mailing address
790 FULLER AVE NE, GRAND RAPIDS, MI 49503-1918
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704344014
MI
Other
Enumeration date
06/22/2020
Last updated
06/22/2020
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