Individual
RYAN SCOTT CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
11160 W J PRESLEY PARKWAY, SUITE 100, ALLENDALE, MI 49401
(616) 252-3900
(616) 252-3920
Mailing address
5900 BYRON CENTER AVE SW, MEDICAL ADMINISTRATION, WYOMING, MI 49519-9606
(616) 252-3900
(616) 252-3920
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704282755
MI
Other
Enumeration date
07/12/2017
Last updated
10/01/2018
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