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1245006709
SHELBY PETERSEN
GRAND RAPIDS, MI
NPI
1245006709
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601012426)
Enumeration Date
2023-11-27
Last Update Date
2024-07-22
Business Address
SHELBY PETERSEN
4100 EMBASSY DR SE STE 400
GRAND RAPIDS, MI 49546-2416
Phone number: 822-061-6988
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Mailing Address
SHELBY PETERSEN
4100 EMBASSY DR SE STE 400
GRAND RAPIDS, MI 49546-2416
Phone number:
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