KEVIN J WIERSUM

GRAND RAPIDS, MI
NPI1699762765
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AS0400X Physician Assistant, Surgical
(Licence: MI  5601004099)
Enumeration Date2005-10-04
Last Update Date2013-09-18
Business Address
-- KEVIN J WIERSUM PAC
1111 LEFFINGWELL AVE NE STE 100
GRAND RAPIDS, MI 49525-6406
Phone number: 616-459-7101
Mailing Address
-- KEVIN J WIERSUM PAC
1111 LEFFINGWELL AVE NE STE 100
GRAND RAPIDS, MI 49525-6406
Phone number: 616-459-7101
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