Individual
MRS. GRACE ELIZABETH FENNEMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3361 36TH ST SE, GRAND RAPIDS, MI 49512-2809
(616) 942-2522
Mailing address
3361 36TH ST SE, GRAND RAPIDS, MI 49512-2809
(616) 942-2522
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
02/19/2017
Last updated
02/19/2017
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