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Individual

DR. DIRK SCHROTENBOER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
11971 JAMES ST, HOLLAND, MI 49424-9610
(616) 395-0606
(616) 395-0070
Mailing address
11971 JAMES ST, HOLLAND, MI 49424-9610
(616) 395-0606
(616) 395-0070

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
521576
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2940256
MI
01
900G065210
BLUECROSS BLUESHIELD ID
MI
Enumeration date
01/31/2006
Last updated
06/23/2010
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