JACK DANIEL DEGROOT

GRAND RAPIDS, MI
NPI1982950960
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: MI  5601006401)
Enumeration Date2012-07-27
Last Update Date2022-02-14
Business Address
JACK DANIEL DEGROOT PA-C
1545 68TH ST SE STE 100
GRAND RAPIDS, MI 49508-7896
Phone number: 616-267-7881
Mailing Address
JACK DANIEL DEGROOT PA-C
100 MICHIGAN ST NE MC 845
GRAND RAPIDS, MI 49503-2560
Phone number:
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