Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology |
NPI | 1194226811 |
---|---|
Provider Name | Pamela Jeanne Munster |
First Address | Grand Rapids, MI 49503-5247 |
Second Address | Grand Rapids, MI 49503-5247 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2018 |
Last Update Date | 27/02/2018 |