Most Relevant Information
Provider Data
| NPI Number: | 1003345455 |
| Provider Name: | COLLETTE VICTORIA PRATT |
| Entity Type: | Individual |
| Taxonomy Code: | 225400000X |
| Specialty: | Rehabilitation Practitioner |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/08/2017 |
| Last Updated: | 06/08/2017 |
Provider Practice Location
1490 EAST BELTLINE AVE SE
GRAND RAPIDS
MI
49506
Practice Location Phone/Fax
| Phone: | 5179270048 |
| Fax: |
Provider Mailing Location
1490 E BELTLINE AVE SE
GRAND RAPIDS
MI
495064336
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |