Individual
KYLE VANBROCKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 CHERRY ST SE, GRAND RAPIDS, MI 49503-4526
(616) 956-8200
Mailing address
746 FULTON ST E # 1, GRAND RAPIDS, MI 49503-4445
(906) 420-0930
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
5351018131
MI
Other
Enumeration date
05/20/2025
Last updated
05/20/2025
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