Individual
DR. MICHAEL KENNETH DISTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1900 WEALTHY ST SE STE 300, GRAND RAPIDS, MI 49506-2969
(616) 774-8345
(616) 774-8350
Mailing address
100 MICHIGAN ST NE, MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301101693
MI
Other
Enumeration date
08/01/2008
Last updated
05/22/2023
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