Individual
CAROLYN TENBROEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
425 E ELM ST, WAYLAND, MI 49348-1109
(269) 792-2249
Mailing address
1611 FORRESTER ST SE, GRAND RAPIDS, MI 49508-1466
(616) 617-0395
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
04/11/2019
Last updated
04/11/2019
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