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1861153736
LAURA A DATEMA
GRAND RAPIDS, MI
NPI
1861153736
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Former Name
LAURA A ODDO
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MI 4704286319)
Enumeration Date
2022-01-04
Last Update Date
2024-04-29
Business Address
LAURA A DATEMA CNP
25 MICHIGAN ST NE STE 4200
GRAND RAPIDS, MI 49503-2559
Phone number: 616-267-9150
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Mailing Address
LAURA A DATEMA CNP
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number: 616-486-6790
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