Individual
LAURA LANETTE OBENAUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1840 WEALTHY ST SE, MC 426, GRAND RAPIDS, MI 49506-2921
(616) 774-5221
(616) 774-5391
Mailing address
PO BOX 1682, GRAND RAPIDS, MI 49501-1682
(616) 774-5221
(616) 774-5391
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003948
MI
Other
Enumeration date
02/17/2006
Last updated
08/13/2007
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