Grace Elizabeth Fennema
Rehabilitation Practitioner in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1982143251
StatusActive
Last updated in NPPESFeb 19, 2017
Details
- NPI
- 1982143251
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Grace Elizabeth Fennema
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 19, 2017
- Last updated
- Feb 19, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225400000X | Rehabilitation Practitioner | – | – | Yes |
Other names
- Grace Elizabeth Bootsma (Former Name)
Practice location
3361 36th St SeGrand Rapids, MI 49512-2809
Phone 616-942-2522
Mailing address
3361 36th St SeGrand Rapids, MI 49512-2809
Phone 616-942-2522
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