Kooistra, Gerald B
Kooistra, Gerald B is an sole proprietor health care provider with primary practice located at 2855 Byron Center Ave Sw , Wyoming MI 49519-2415. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Kooistra, Gerald B can be contacted via phone (616) 532-2518.Contact Information
Primary practice address
2855 Byron Center Ave Sw
Wyoming MI 49519-2415
Phone: (616) 532-2518
Fax: (616) 532-2696
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | GK001962 | Michigan |
Profile Details
| NPI number | 1881680403 |
|---|---|
| LBN Legal business name | Kooistra, Gerald B |
| Credentials | Doctor of Chiropractic (DC) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2005 |
| Last updated | Sep 11th, 2009 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1881680403 | NPPES |
| Michigan | MEDICAID | 1005146 | |
| Michigan | Other | 950D150290 |
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