Individual
DR. AMANDA RUDERT HOLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3271 CLEAR VISTA CT NE, GRAND RAPIDS, MI 49525
(616) 267-7125
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
5101020432
MI
208000000X
Pediatrics Physician
5101020432
MI
Other
Enumeration date
06/17/2013
Last updated
02/17/2021
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