Individual
MR. MATTHEW WILLIAM DYKSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
221 MICHIGAN ST NE STE 300, GRAND RAPIDS, MI 49503-2537
(616) 459-7258
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704309350
MI
Other
Enumeration date
01/05/2021
Last updated
08/01/2022
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