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Holly Banninga, PTA
NPI 1477800357 · on the registry since 2012 · sole proprietor
Practice
- Address
- 1471 Grace St Se
Grand Rapids, MI 49506 - Phone
- (616) 913-2006
- Clinicians at this address
- 27
Registry record
- Primary taxonomy
- 225200000X
225200000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2012-08-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan