Individual
MR. NICHOLAS H PHELPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1115 BALL AVE NE, GRAND RAPIDS, MI 49505-5904
(616) 456-6571
Mailing address
7412 PHEASANT RUN DR, HUDSONVILLE, MI 49426-9171
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
06/06/2022
Last updated
06/06/2022
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