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1134144413
JACK O DERKS
HOLLAND, MI
NPI
1134144413
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MI 4301028907)
Enumeration Date
2006-07-13
Last Update Date
2007-12-11
Business Address
JACK O DERKS MD
601 MICHIGAN AVE STE 104
HOLLAND, MI 49423-4951
Phone number: 616-392-2361
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Mailing Address
JACK O DERKS MD
601 MICHIGAN AVE STE 104
HOLLAND, MI 49423-4951
Phone number: 616-392-2361
Copy
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