Individual
BRIAN WILLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
370 N 120TH AVE, HOLLAND, MI 49424-2196
(616) 396-5855
(616) 396-5720
Mailing address
370 N 120TH AVE, HOLLAND, MI 49424-2196
(616) 396-5855
(616) 396-5720
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5601007254
MI
Other
Enumeration date
12/30/2014
Last updated
12/30/2014
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