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1205522919
SEBASTIAN TARO JEWELL-WIERTALLA
GRAND RAPIDS, MI
NPI
1205522919
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
106S00000X Behavior Technician
Enumeration Date
2023-04-14
Last Update Date
2023-04-14
Business Address
SEBASTIAN TARO JEWELL-WIERTALLA
120 STEVENS ST SW
GRAND RAPIDS, MI 49507-1526
Phone number: 855-832-6727
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Mailing Address
SEBASTIAN TARO JEWELL-WIERTALLA
PO BOX 150652
GRAND RAPIDS, MI 49515-0652
Phone number: 231-633-9516
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