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1093028441
LONNA PETRONELLA VAN AST
GRAND RAPIDS, MI
NPI
1093028441
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: MI 5601002990)
Enumeration Date
2010-07-14
Last Update Date
2013-07-29
Business Address
Mrs. LONNA PETRONELLA VAN AST P.A.
1022 ADA PLACE DR SE
GRAND RAPIDS, MI 49546-3786
Phone number: 616-550-0427
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Mailing Address
Mrs. LONNA PETRONELLA VAN AST P.A.
1022 ADA PLACE DR SE
GRAND RAPIDS, MI 49546-3786
Phone number:
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