Audrey Jagt
NPI #1154679348 in Grand Rapids, Michigan
Provider Information
- NPI Number
- 1154679348
- Entity Type
- Individual
- Name
- Audrey Jagt
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist/Technologist, Other
- Enumeration Date
- Aug 21, 2012
- Last Updated
- Aug 21, 2012
Practice Location
- Address
- 1490 E BELTLINE AVE SE
- City
- Grand Rapids
- State
- Michigan
- ZIP Code
- 49506-4336
- Phone
- (616) 940-0040
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist, Other |
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