Individual
MR. SCOTT MATTHEW STANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS, ETS
Contact information
Practice address
1490 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(616) 540-6078
Mailing address
1490 E BELTLINE AVE SE, GRAND RAPIDS, MI 49506-4336
(616) 540-6078
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/09/2010
Last updated
06/10/2010
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