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1538774849
GRACE MIERENDORF
GRAND RAPIDS, MI
NPI
1538774849
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MI 2601002645)
Enumeration Date
2020-09-14
Last Update Date
2024-11-08
Business Address
GRACE MIERENDORF LAT, ATC
2770 E BELTLINE AVE NE
GRAND RAPIDS, MI 49525-8614
Phone number: 616-267-7000
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Mailing Address
GRACE MIERENDORF LAT, ATC
820 MEADOW DR
WAYLAND, MI 49348-1369
Phone number: 269-680-9159
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