ZACHARY MICHAEL DEFOUW

GRAND RAPIDS, MI
NPI1346048717
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363A00000X Physician Assistant
(Licence: CA  PA67003)
Additional Taxonomies363AS0400X Physician Assistant, Surgical
363AM0700X Physician Assistant, Medical
Enumeration Date2025-03-03
Last Update Date2025-09-24
Business Address
Mr. ZACHARY MICHAEL DEFOUW
1800 HAINES ST NW
GRAND RAPIDS, MI 49504-3958
Phone number: 616-901-3242
Mailing Address
Mr. ZACHARY MICHAEL DEFOUW
1800 HAINES ST NW
GRAND RAPIDS, MI 49504-3958
Phone number: 616-901-3242