Individual
DR. BRENT VAN TIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
904 WASHINGTON AVE STE 130, HOLLAND, MI 49423-7724
(616) 392-7472
(616) 392-3327
Mailing address
904 WASHINGTON AVE STE 130, HOLLAND, MI 49423-7724
(616) 392-7472
(616) 392-3327
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
5901002387
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5901002387
LICENSE
MI
Enumeration date
08/25/2008
Last updated
12/16/2013
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