Individual
KORTNE CUSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.A. -C
Contact information
Practice address
555 MIDTOWNE ST NE, GRAND RAPIDS, MI 49503-5729
(616) 588-8880
Mailing address
3140 HALL ST SE, GRAND RAPIDS, MI 49506-3171
(616) 634-9195
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005349
MI
Other
Enumeration date
09/26/2008
Last updated
01/09/2015
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