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1114429883
LISA ANNE ETHINGTON
GRAND RAPIDS, MI
NPI
1114429883
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MI 55001004153)
Enumeration Date
2018-03-08
Last Update Date
2018-03-08
Business Address
LISA ANNE ETHINGTON
80 68TH ST SE
GRAND RAPIDS, MI 49548-6980
Phone number: 616-391-8215
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Mailing Address
LISA ANNE ETHINGTON
80 68TH ST SE
GRAND RAPIDS, MI 49548-6980
Phone number: 616-391-8215
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