JACQUELINE S JOHANSON

GRAND RAPIDS, MI
NPI1952304982
Former NameJACQUELINE S DASCOLA
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  5601008301)
Enumeration Date2005-05-23
Last Update Date2021-12-28
Business Address
Mrs. JACQUELINE S JOHANSON P.A.-C
310 LAFAYETTE AVE SE STE 410
GRAND RAPIDS, MI 49503-4693
Phone number: 616-685-8200
Mailing Address
Mrs. JACQUELINE S JOHANSON P.A.-C
310 LAFAYETTE AVE SE STE 410
GRAND RAPIDS, MI 49503-4693
Phone number: 616-685-8200
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