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1649476789
JOANNE KAREN ICKSTADT
GRAND RAPIDS, MI
NPI
1649476789
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WA PT00010467)
Enumeration Date
2007-06-25
Last Update Date
2007-07-08
Business Address
JOANNE KAREN ICKSTADT P.T.
2900 CHARLEVOIX DR SE SUITE #200
GRAND RAPIDS, MI 49546-7085
Phone number: 800-634-1077
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Mailing Address
JOANNE KAREN ICKSTADT P.T.
860 3 CRABS RD
SEQUIM, WA 98382-7852
Phone number: 719-510-6420
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