Individual
MACKENZIE ELIZABETH ONDERSMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
111 LYON ST, GRAND RAPIDS, MI 49503
(616) 234-4260
Mailing address
143 BOSTWICK AVE NE, GRAND RAPIDS, MI 49503-3201
(616) 234-4260
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601002802
MI
2255A2300X
Athletic Trainer
TCA891
KY
Other
Enumeration date
12/04/2019
Last updated
06/29/2023
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