Individual
JASON ALEXANDER MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
156 LEXINGTON AVE NW, GRAND RAPIDS, MI 49504-5649
(616) 706-4487
Mailing address
156 LEXINGTON AVE NW, GRAND RAPIDS, MI 49504-5649
(616) 706-4487
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703122754
MI
Other
Enumeration date
06/02/2020
Last updated
06/02/2020
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