BRENT TANNIN TABATA

GRAND RAPIDS, MI
NPI1922702638
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: MI  973751)
Enumeration Date2023-03-28
Last Update Date2023-06-05
Business Address
BRENT TANNIN TABATA MS, RD
360 LAFAYETTE AVE SE STE 400
GRAND RAPIDS, MI 49503-4677
Phone number: 616-486-6870
Mailing Address
BRENT TANNIN TABATA MS, RD
100 MICHIGAN ST NE # MC845
GRAND RAPIDS, MI 49503-2560
Phone number: