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1194269860
JENNA MARIE PRIETO
GRAND RAPIDS, MI
NPI
1194269860
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Former Name
JENNA MARIE FREDRICKSON
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601008048)
Enumeration Date
2016-12-14
Last Update Date
2022-03-28
Business Address
JENNA MARIE PRIETO
4100 LAKE DR SE STE B01
GRAND RAPIDS, MI 49546-8292
Phone number: 616-267-7400
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Mailing Address
JENNA MARIE PRIETO
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number:
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