Individual
LEON VANDERLAAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1108 W STATE ST, HASTINGS, MI 49058-9711
(269) 948-3102
(269) 948-5891
Mailing address
100 MICHIGAN ST NE MC-845, GRAND RAPIDS, MI 49503-2560
(616) 486-6790
(616) 486-6702
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601001241
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104840529
BCBSM - BRONSON URGENT CARE
MI
Enumeration date
05/25/2006
Last updated
05/15/2017
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