Individual
LESLIE A BOONSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
550 CHERRY ST SE, GRAND RAPIDS, MI 49503-4748
(616) 235-7272
(616) 776-2122
Mailing address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 965-8200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004592
MI
Other
Enumeration date
02/22/2007
Last updated
12/26/2012
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