MELISSA A KOOISTRA

PORTAGE, 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 Date2024-12-20
Business Address
MELISSA A KOOISTRA PA
7920 KIRKLAND CT
PORTAGE, MI 49024-4974
Phone number: 269-345-8618
Mailing Address
MELISSA A KOOISTRA PA
7920 KIRKLAND CT
PORTAGE, MI 49024-4974
Phone number: 269-345-8618
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