Individual
JOHN S PELLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS,LLP
Contact information
Practice address
1700 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-7044
(616) 222-3720
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 455-5000
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301006900
MI
Other
Enumeration date
07/19/2006
Last updated
07/08/2007
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