Individual
DEREK LEE WAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1175 WILSON AVE NW, GRAND RAPIDS, MI 49534-6407
(616) 577-8183
Mailing address
625 KENMOOR AVE SE STE 100, GRAND RAPIDS, MI 49546-2395
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501303835
MI
Other
Enumeration date
02/17/2025
Last updated
02/17/2025
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