Individual
ANDREA LEIGH SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3584 FAIRLANES AVE SW STE 2, GRANDVILLE, MI 49418-1583
(616) 222-5300
Mailing address
3584 FAIRLANES AVE SW STE 2, GRANDVILLE, MI 49418-1583
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703102830
MI
Other
Enumeration date
02/06/2019
Last updated
02/06/2019
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