Individual
HANNAH M DECLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AT
Contact information
Practice address
5060 CASCADE RD SE STE A, GRAND RAPIDS, MI 49546-3808
(616) 954-0695
Mailing address
5060 CASCADE RD SE STE A, GRAND RAPIDS, MI 49546-3808
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
2601000326
MI
Other
Enumeration date
06/29/2016
Last updated
06/29/2016
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