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1700319647
ALEXANDRA KATHERINE SHIELDS
GRAND RAPIDS, MI
NPI
1700319647
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Former Name
ALEXANDRA KATHERINE OLDS
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2017-04-07
Last Update Date
2023-01-18
Business Address
ALEXANDRA KATHERINE SHIELDS PA
100 MICHIGAN ST NE
GRAND RAPIDS, MI 49503-2560
Phone number: 616-391-2802
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Mailing Address
ALEXANDRA KATHERINE SHIELDS PA
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number:
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