Provider Demographics
NPI:1174802573
Name:NOEL, ADELE ANN (MMT-P)
Entity type:Individual
Prefix:MRS
First Name:ADELE
Middle Name:ANN
Last Name:NOEL
Suffix:
Gender:F
Credentials:MMT-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 BUTTERWORTH ST SW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-6254
Mailing Address - Country:US
Mailing Address - Phone:616-318-4402
Mailing Address - Fax:
Practice Address - Street 1:818 BUTTERWORTH ST SW
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49504-6254
Practice Address - Country:US
Practice Address - Phone:616-318-4402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist