Lori Lynn Koorndyk PA-C

NPI 1154621175 - Physician Assistant - 363A00000X

NPI Details
NPI 1154621175
Gender Female
Enumeration Date 10/25/2010
Last Updated 10/25/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
436 44TH ST SE
SUITE A
GRAND RAPIDS MI, 49548-4371, US
Phone (616) 531-9750
Fax
Business Location
1996 CONIFER RIDGE DR SW
BYRON CENTER MI, 49315-7950, US
Phone (616) 583-9799
Fax
Toxanomy
Taxonomy Code 363A00000X
License State Michigan
License Number 5601003298
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According to our database, Mrs. Lori Lynn Koorndyk PA-C NPI is 1154621175, taxonomy code is 363A00000X and license number is 5601003298, license state is located at Michigan. Lori Lynn Koorndyk PA-C physically located at 436 44th St Se, Grand Rapids MI, 49548-4371. NPI Number Lori Lynn Koorndyk PA-C has the Individual type.

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1154621175 NPI number is provided on an as is basis without warranty of any kind. 1154621175 is maintained by the National Plan & Provider Enumeration System. The contents of Lori Lynn Koorndyk PA-C are for informational purposes only.