Individual
COURTNEY ANN VANDEWEGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
2211 LAKE DR SE, GRAND RAPIDS, MI 49506-3026
(616) 322-3145
Mailing address
5480 PARK AVE, HUDSONVILLE, MI 49426-1245
(616) 322-3145
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/12/2006
Last updated
07/08/2007
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