Individual
SHELBY HEYBOER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2786 56TH ST SW, WYOMING, MI 49418-8708
(616) 261-3960
Mailing address
614 146TH AVE, CALEDONIA, MI 49316-9210
(616) 514-2691
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
5202002443
MI
Other
Enumeration date
04/23/2015
Last updated
04/23/2015
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