Individual
JADE A PASKEWICZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC/L
Contact information
Practice address
4100 LAKE DR SE STE 305, GRAND RAPIDS, MI 49546-8292
(616) 267-8860
Mailing address
4559 GRANTWOOD AVE SE, KENTWOOD, MI 49508-4533
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601000350
MI
Other
Enumeration date
04/30/2012
Last updated
04/30/2012
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