MELISSA A KOOISTRA

GRAND RAPIDS, MI
NPI1346260007
Former NameMELISSA A VANTOL
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  5601004250)
Enumeration Date2006-07-19
Last Update Date2007-07-08
Business Address
-- MELISSA A KOOISTRA PA
1840 WEALTHY ST SE MC 426
GRAND RAPIDS, MI 49506-2921
Phone number: 616-774-5221
Mailing Address
-- MELISSA A KOOISTRA PA
PO BOX 1682
GRAND RAPIDS, MI 49501-1682
Phone number: 616-774-5221
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