Individual
AMANDA NOVAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 JEFFERSON AVE SE, GRAND RAPIDS, MI 49503-4502
(616) 754-5036
(616) 754-4380
Mailing address
5555 GLENWOOD HILLS PKWY SE STE 2, GRAND RAPIDS, MI 49512-2091
(616) 940-2662
(616) 685-1850
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006053
MI
Other
Enumeration date
06/03/2011
Last updated
05/10/2021
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