Individual
KEVIN VANDER SLIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2697 CUTLASS ST, WAYLAND, MI 49348-9469
(616) 292-0544
Mailing address
2697 CUTLASS ST, WAYLAND, MI 49348-9469
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703111586
MI
Other
Enumeration date
02/07/2020
Last updated
02/07/2020
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