Individual
MALLORY VANREGENMORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7150 KALAMAZOO AVE SE STE B, CALEDONIA, MI 49316-9197
(616) 333-1800
(616) 803-5323
Mailing address
5060 CASCADE RD SE STE A, GRAND RAPIDS, MI 49546-3808
(616) 333-1800
(616) 803-5323
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201011417
MI
Other
Enumeration date
09/08/2021
Last updated
09/16/2021
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