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Individual

SAMANTHA FORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ATC

Contact information

Practice address
4100 LAKE DR SE, GRAND RAPIDS, MI 49546-8292
(616) 267-8860
Mailing address
4100 LAKE DR SE, GRAND RAPIDS, MI 49546-8292

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1576
AL

Other

Enumeration date
08/26/2015
Last updated
08/26/2015
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