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1881647501
JODY BANISTER
GRAND RAPIDS, MI
NPI
1881647501
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: MI 4301076654)
Enumeration Date
2006-05-17
Last Update Date
2010-10-05
Business Address
-- JODY BANISTER MD
300 LAFAYETTE AVE SE SUITE 3000
GRAND RAPIDS, MI 49503-4650
Phone number: 616-685-6919
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Mailing Address
-- JODY BANISTER MD
245 STATE ST SE
GRAND RAPIDS, MI 49503-4328
Phone number: 616-685-1808
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