Individual
LISA DEGROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1853 R W BERENDS DR SW, WYOMING, MI 49519-4955
(616) 534-9300
Mailing address
4114 21ST ST, DORR, MI 49323-9569
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704244579
MI
Other
Enumeration date
07/21/2021
Last updated
07/21/2021
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