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1164765681
JOHNATHON MITT WILSON
GRAND RAPIDS, MI
NPI
1164765681
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2013-04-03
Last Update Date
2013-04-03
Business Address
-- JOHNATHON MITT WILSON B.S.W
781 36TH ST SE
GRAND RAPIDS, MI 49548-2319
Phone number: 734-395-8652
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Mailing Address
-- JOHNATHON MITT WILSON B.S.W
PO BOX 141
GRAND RAPIDS, MI 49501-0141
Phone number: 734-395-8652
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