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1215193917
MICHAEL KENNETH DISTLER
GRAND RAPIDS, MI
NPI
1215193917
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
208100000X Physical Medicine & Rehabilitation
(Licence: MI 4301101693)
Enumeration Date
2008-08-01
Last Update Date
2023-05-22
Business Address
Dr. MICHAEL KENNETH DISTLER
1900 WEALTHY ST SE STE 300
GRAND RAPIDS, MI 49506-2969
Phone number: 616-774-8345
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Mailing Address
Dr. MICHAEL KENNETH DISTLER
100 MICHIGAN ST NE MC845
GRAND RAPIDS, MI 49503-2560
Phone number:
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