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1184193617
ANNELISE ELIZABETH MEDINA
GRAND RAPIDS, MI
NPI
1184193617
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
3747A0650X Technician, Attendant Care Provider
Enumeration Date
2018-11-14
Last Update Date
2018-11-14
Business Address
ANNELISE ELIZABETH MEDINA
1490 E BELTLINE AVE SE
GRAND RAPIDS, MI 49506-4336
Phone number: 616-940-0040
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Mailing Address
ANNELISE ELIZABETH MEDINA
4393 DIVISION ST
WAYLAND, MI 49348-9786
Phone number: 269-397-0527
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