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1396842621
TARA JANSEN
GRAND RAPIDS, MI
NPI
1396842621
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MI 5501012974)
Enumeration Date
2006-09-20
Last Update Date
2009-10-28
Business Address
-- TARA JANSEN P.T.
428 BRIDGE ST NW
GRAND RAPIDS, MI 49504-5322
Phone number: 616-451-4284
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Mailing Address
-- TARA JANSEN P.T.
3828 44TH ST. SE
KENTWOOD, MI 49512
Phone number:
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