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1821554031
MARY VANDERWAL
GRAND RAPIDS, MI
NPI
1821554031
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: MI 5202004267)
Enumeration Date
2019-02-12
Last Update Date
2019-02-12
Business Address
Mrs. MARY VANDERWAL COTAL, DOR
2320 E BELTLINE AVE SE
GRAND RAPIDS, MI 49546-5906
Phone number: 616-831-8643
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Mailing Address
Mrs. MARY VANDERWAL COTAL, DOR
9199 WHITNEYVILLE AVE SE
ALTO, MI 49302-9567
Phone number: 616-292-5760
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