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1326669391
JACK M TIETEMA
GRAND RAPIDS, MI
NPI
1326669391
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2020-05-01
Last Update Date
2020-05-01
Business Address
JACK M TIETEMA
1490 E BELTLINE AVE SE
GRAND RAPIDS, MI 49506-4336
Phone number: 855-407-7575
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Mailing Address
JACK M TIETEMA
1490 E BELTLINE AVE SE
GRAND RAPIDS, MI 49506-4336
Phone number: 855-407-7575
Copy
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