Individual
JAKE JOSEPH CARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1115 BALL AVE NE, GRAND RAPIDS, MI 49505-5904
(616) 456-8010
Mailing address
1712 N GREENFIELD CIR NE, APT 102, GRAND RAPIDS, MI 49505-5675
(616) 502-3881
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
11/30/2015
Last updated
11/30/2015
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