Individual
ASHLEY F DALSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4100 LAKE DR SE STE 300, GRAND RAPIDS, MI 49546
(616) 267-8860
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008624
MI
Other
Enumeration date
06/20/2013
Last updated
08/27/2018
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