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1053414128
DIANA LIGHTFOOT
GRAND RAPIDS, MI
NPI
1053414128
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601004545)
Enumeration Date
2006-09-06
Last Update Date
2007-07-08
Business Address
-- DIANA LIGHTFOOT PA
2332 ALPINE AVE NW
GRAND RAPIDS, MI 49544-1955
Phone number: 616-391-6220
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Mailing Address
-- DIANA LIGHTFOOT PA
100 MICHIGAN ST NE MC 109 ATTN JULIE L
GRAND RAPIDS, MI 49503-2560
Phone number:
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