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Organization
PHYSICIAN'S HOME NETWORK, PLLC
Active
Organization
PHYSICIAN'S HOME NETWORK, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KURTIS SMITKO MSPT (CEO)
(616) 608-7403
Entity
Organization
Contact information
Practice address
3033 ORCHARD VISTA DR SE, SUITE 309, GRAND RAPIDS, MI 49546-7077
(616) 608-7403
(616) 608-7408
Mailing address
3033 ORCHARD VISTA DR SE, SUITE 309, GRAND RAPIDS, MI 49546-7077
(616) 608-7403
(616) 608-7408
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
NULL
207QA0505X
Adult Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363LA2200X
Adult Health Nurse Practitioner
—
NULL
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
11/05/2009
Last updated
11/05/2009
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