LISA JANE EALY CAVANAUGH

GRAND RAPIDS, MI
NPI1245658657
Former NameLISA JANE EALY
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  5601006950)
Enumeration Date2014-04-02
Last Update Date2021-02-22
Business Address
LISA JANE EALY CAVANAUGH
100 MICHIGAN ST NE SUITE A721
GRAND RAPIDS, MI 49503-2560
Phone number: 616-391-3139
Mailing Address
LISA JANE EALY CAVANAUGH
100 MICHIGAN ST NE MC 845
GRAND RAPIDS, MI 49503-2560
Phone number:
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