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Individual

ERIN L VANDYKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746
(616) 363-7339
(616) 361-5828
Mailing address
3264 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9746

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601004512
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5601004512
PA LICENSE
MI
Enumeration date
02/28/2007
Last updated
07/28/2017
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