Individual
MRS. SALLY JO MOUNTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1450 LEONARD ST NE, GRAND RAPIDS, MI 49505-5515
(616) 774-8789
(616) 774-2072
Mailing address
1450 LEONARD ST NE, GRAND RAPIDS, MI 49505-5515
(616) 774-8789
(616) 774-2072
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704150174
MI
Other
Enumeration date
12/23/2009
Last updated
12/23/2009
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