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1033149638
JENNIFER VANDERWALL
GRAND RAPIDS, MI
NPI
1033149638
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601004566)
Enumeration Date
2006-07-03
Last Update Date
2011-11-02
Business Address
-- JENNIFER VANDERWALL PA-C
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503-2560
Phone number: 616-391-1680
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Mailing Address
-- JENNIFER VANDERWALL PA-C
2537 MOMENTUM PL
CHICAGO, IL 60689-5325
Phone number: 616-975-1845
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