Individual
WENDY CORELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, AT., ATC
Contact information
Practice address
6191 KRAFT AVE SE, GRAND RAPIDS, MI 49512-9396
(616) 871-6186
Mailing address
15096 OAKLAND ST, SPRING LAKE, MI 49456-2721
(616) 566-7924
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000718
MI
Other
Enumeration date
07/23/2014
Last updated
07/23/2014
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