Individual
MRS. CORAZON MANEJO VILLANUEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1401 CEDAR ST NE, GRAND RAPIDS, MI 49503-1375
(844) 702-4663
Mailing address
2456 WHISPERING MEADOWS CT SE, KENTWOOD, MI 49512-3703
(734) 775-1728
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501004450
MI
Other
Enumeration date
03/07/2018
Last updated
03/07/2018
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