Organization
DG SURGICAL-NASHVILLE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GORDON JOHN BRUINSMA (MANAGING MEMBER)
(616) 293-4769
Entity
Organization
Contact information
Practice address
1821 N WASHINGTON ST # 2221, TULLAHOMA, TN 37388-2221
(931) 455-2005
Mailing address
3910 BRIGADOON CT SW, BYRON CENTER, MI 49315-8581
(616) 293-4769
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
12/13/2021
Last updated
12/13/2021
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