Individual
REBECCA JOHANNA HILLEGONDA GROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
286 HOOVER BLVD, HOLLAND, MI 49423-3719
(616) 392-2172
(616) 392-1726
Mailing address
286 HOOVER BLVD, HOLLAND, MI 49423-3719
(616) 392-2172
(616) 392-1726
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005176
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5502005176
MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS: STATE LICENSE
MI
Enumeration date
09/21/2018
Last updated
09/21/2018
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